Somatization

Somatization

Definition:

Somatization disorder is along –term (chronic) condition in which a person has physical symptoms that involve more than one part of the body ,but no physical cause can be found.

The pain and other symptoms people with this disorder feel are real, and are not created or faked on purpose (malingering)

Causes:

The disorder usually begins before age 30 and occur more often in women than in men .the disorder is more common in people with IBS and chronic pain.

Symptoms:

 Many Physical complaints that last for years .  Most often the complaints involve chronic pain and problems with the digestive system  , CNS , and reproductive system.

The symptoms  often interfere with work , relationships, and lead to many visits to different health care providers.

Symptoms includes:

Abdominal pain

Back pain 

Chest pain 

Diarrhea

Difficulty swallowing

Headache

Nausea and sometimes vomiting

Pain during intercourse

Pain during urination

Pain during menstruation

Palpitations

Paralysis or muscle weakness

Vision changes

Exams and Tests:

Physical examination and diagnostic tests are perform to identify physical causes, no physical  cause is found to explain the symptoms , somatization disorder may be diagnosed.

A psychological evaluation is performed to  identify related  disorders.

Treatment:

The goal of treatment is to help patients to control their symptoms.

Having supportive  relationship with a health care provider is the most important part of treatment.

You should have only one primary care provider, to avoid having too many tests and procedures.

Schedule regular appointments to review the symptoms and how you are coping.  The  health care provider should  explain any test results.

Psychotherapy can be helpful

Cognitive behavioral therapy (CBT) can help you deal with your pain.

If the condition associated with  depression or anxiety antidepressants can help.

Conversion disorders

(dissociative & also called functional  neurological symptoms disorders)

Definition:

Is a condition in which pt show psychological  stress in physical ways(loss or disturbance of normal motor or sensory function which initially appears to have a neurological or others physical cause.

Clinical features:

May appears suddenly after stressful event or trauma.  Sign& Symptoms that affect movement function may include:

Weakness or paralysis

Abnormal movement, such as tremors or difficulty walking

Loss of balance

Difficulty swallowing or lump in the throat

Seizures or convulsions

Sign& Symptoms that affect the senses may include:

Numbness or loss Of the touch sensation

Speech problems, such as inability to speak or slurred speech

Vision problems such as double vision or blindness

Hearing problems or deafness

Amnesia (memory loss)

Causes

The exact cause of conversion disorder is unknown

Nearly always triggered by a stressful event , and emotional conflict or another mental health disorder, such as depression.

Diagnosis

Usually be suspected due to the non-anatomical or clinically inconsistent nature of the signs

Risk factors

Recent significant stress or emotional trauma

Being female

Having a mental health condition, such as anxiety disorders , or certain personality disorders

Having a neurological disease that cause similar symptoms ,such as epilepsy

Having a family member with conversion disorders

Treatment:

Counseling( psychotherapy) , reassurance ,supportive, and family therapy

CBT

IPT

Prognosis

For acute symptoms, especially those with a clear precipitant, the prognosis is good, with expectation of complete resolution of symptoms (70-90%)

Poorer outcomes for longer-lasting and well-established symptoms

Thank you

&

Best wishes

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ADD / ADHD in Children

Signs and Symptoms of Attention Deficit Disorder in Kids

In This ArticleIt’s normal for children to occasionally forget their homework, daydream during class, act without thinking, or get fidgety at the dinner table. But inattention, impulsivity, and hyperactivity are also signs of attention deficit disorder (ADD/ADHD), which can affect your child’s ability to learn and get along with others. The first step to addressing the problem is to recognize the signs and symptoms.

What is ADD / ADHD?

We all know kids who can’t sit still, who never seem to listen, who don’t follow instructions no matter how clearly you present them, or who blurt out inappropriate comments at inappropriate times. Sometimes these children are labeled as troublemakers, or criticized for being lazy and undisciplined. However, they may have ADD/ADHD.
Attention deficit hyperactivity disorder (ADHD) is a disorder that appears in early childhood. You may know it by the name attention deficit disorder, or ADD. ADD/ADHD makes it difficult for people to inhibit their spontaneous responses—responses that can involve everything from movement to speech to attentiveness.

Is it normal kid behavior or is it ADHD?

The signs and symptoms of ADD/ADHD typically appear before the age of seven. However, it can be difficult to distinguish between attention deficit disorder and normal “kid behavior.”
If you spot just a few signs, or the symptoms appear only in some situations, it’s probably not ADD/ADHD. On the other hand, if your child shows a number of ADD/ADHD signs and symptoms that are present across all situations—at home, at school, and at play—it’s time to take a closer look.
Once you understand the issues your child is struggling with, such as forgetfulness or difficulty paying attention in school, you can work together to find creative solutions and capitalize on strengths.

Myths about Attention Deficit Disorder
MYTH #1: All kids with ADD/ADHD are hyperactive. FACT: Some children with ADD/ADHD are hyperactive, but many others with attention problems are not. Children with ADD/ADHD who are inattentive, but not overly active, may appear to be spacey and unmotivated.
MYTH #2: Kids with ADD/ADHD can never pay attention. FACT: Children with ADD/ADHD are often able to concentrate on activities they enjoy. But no matter how hard they try, they have trouble maintaining focus when the task at hand is boring or repetitive.
MYTH #3: Kids with ADD/ADHD could behave better if they wanted to. FACT: Children with ADD/ADHD may do their best to be good, but still be unable to sit still, stay quiet, or pay attention. They may appear disobedient, but that doesn’t mean they’re acting out on purpose.
MYTH #4: Kids will eventually grow out of ADD/ADHD. FACT: ADD/ADHD often continues into adulthood, so don’t wait for your child to outgrow the problem. Treatment can help your child learn to manage and minimize the symptoms.
MYTH #5: Medication is the best treatment option for ADD/ADHD. FACT: Medication is often prescribed for attention deficit disorder, but it might not be the best option for your child. Effective treatment for ADD/ADHD also includes education, behavior therapy, support at home and school, exercise, and proper nutrition.

The primary characteristics of ADD / ADHD

When many people think of attention deficit disorder, they picture an out-of-control kid in constant motion, bouncing off the walls and disrupting everyone around. But this is not the only possible picture.
Some children with ADD/ADHD are hyperactive, while others sit quietly—with their attention miles away. Some put too much focus on a task and have trouble shifting it to something else. Others are only mildly inattentive, but overly impulsive.

The three primary characteristics of ADD / ADHD

The three primary characteristics of ADD/ADHD are inattention, hyperactivity, and impulsivity. The signs and symptoms a child with attention deficit disorder has depends on which characteristics predominate.

Which one of these children may have ADD/ADHD?

1. The hyperactive boy who talks nonstop and can’t sit still.
2. The quiet dreamer who sits at her desk and stares off into space.
3. Both A and B

The correct answer is “C.”

Children with ADD/ADHD may be:

• Inattentive, but not hyperactive or impulsive.
• Hyperactive and impulsive, but able to pay attention.
• Inattentive, hyperactive, and impulsive (the most common form of ADD/ADHD).

Children who only have inattentive symptoms of ADD/ADHD are often overlooked, since they’re not disruptive. However, the symptoms of inattention have consequences: getting in hot water with parents and teachers for not following directions; underperforming in school; or clashing with other kids over not playing by the rules.

Spotting ADD / ADHD at different ages

Because we expect very young children to be easily distractible and hyperactive, it’s the impulsive behaviors—the dangerous climb, the blurted insult—that often stand out in preschoolers with ADD/ADHD.
By age four or five, though, most children have learned how to pay attention to others, to sit quietly when instructed to, and not to say everything that pops into their heads. So by the time children reach school age, those with ADD/ADHD stand out in all three behaviors: inattentiveness, hyperactivity, and impulsivity.

Inattentiveness signs and symptoms of ADD/ADHD

It isn’t that children with ADD/ADHD can’t pay attention: when they’re doing things they enjoy or hearing about topics in which they’re interested, they have no trouble focusing and staying on task. But when the task is repetitive or boring, they quickly tune out.
Staying on track is another common problem. Children with ADD/ADHD often bounce from task to task without completing any of them, or skip necessary steps in procedures. Organizing their schoolwork and their time is harder for them than it is for most children.
Kids with ADD/ADHD also have trouble concentrating if there are things going on around them; they usually need a calm, quiet environment in order to stay focused.

Symptoms of inattention in children:

• Doesn’t pay attention to details
• Makes careless mistakes
• Has trouble staying focused; is easily distracted
• Appears not to listen when spoken to
• Has difficulty remembering things and following instructions
• Has trouble staying organized, planning ahead, and finishing projects
• Gets bored with a task before it’s completed
• Frequently loses or misplaces homework, books, toys, or other items

Hyperactivity signs and symptoms of ADD/ADHD

The most obvious sign of ADD/ADHD is hyperactivity. While many children are naturally quite active, kids with hyperactive symptoms of attention deficit disorder are always moving.
They may try to do several things at once, bouncing around from one activity to the next. Even when forced to sit still which can be very difficult for them their foot is tapping, their leg is shaking, or their fingers are drumming.

Symptoms of hyperactivity in children:

• Constantly fidgets and squirms
• Often leaves his or her seat in situations where sitting quietly is expected
• Moves around constantly, often runs or climbs inappropriately
• Talks excessively
• Has difficulty playing quietly or relaxing
• Is always “on the go,” as if driven by a motor
• May have a quick temper or a “short fuse” 

Impulsive signs and symptoms of ADD/ADHD

The impulsivity of children with ADD/ADHD can cause problems with self-control. Because they censor themselves less than other kids do, they’ll interrupt conversations, invade other people’s space, ask irrelevant questions in class, make tactless observations, and ask overly personal questions.
Instructions like “Be patient” and “Just wait a little while” are twice as hard for children with ADD/ADHD to follow as they are for other youngsters.
Children with impulsive signs and symptoms of ADD/ADHD also tend to be moody and to overreact emotionally. As a result, others may start to view the child as disrespectful, weird, or needy.

Symptoms of impulsivity in children:

• Acts without thinking
• Blurts out answers in class without waiting to be called on or hear the whole question
• Can’t wait for his or her turn in line or in games
• Says the wrong thing at the wrong time
• Often interrupts others
• Intrudes on other people’s conversations or games
• Inability to keep powerful emotions in check, resulting in angry outbursts or temper tantrums
• Guesses, rather than taking time to solve a problem

Is it really ADD / ADHD?

Just because a child has symptoms of inattention, impulsivity, or hyperactivity does not mean that he or she has ADD or ADHD. Certain medical conditions, psychological disorders, and stressful life events can cause symptoms that look like ADD / ADHD.
Before an accurate diagnosis of ADD / ADHD can be made, it is important that you see a mental health professional to explore and rule out the following possibilities:

• Learning disabilities or problems with reading, writing, motor skills, or language.
• Major life events or traumatic experiences (e.g. a recent move, death of a loved one, bullying, divorce).
• Psychological disorders including anxiety,depression, and bipolar disorder.
• Behavioral disorders such as conduct disorder and oppositional defiant disorder.
• Medical conditions, including thyroid problems, neurological conditions, epilepsy, and sleep disorders.

A learning disability may be mistaken for ADHD

Think your child has attention deficit disorder? Sometimes, kids who are having trouble in school are incorrectly diagnosed with ADD/ADHD, when what they really have is a learning disability. Furthermore, many kids struggle with both ADD/ADHD and a learning disability.

Positive effects of ADD / ADHD in children

In addition to the challenges, there are also positive traits associated with people who have attention deficit disorder:

• Creativity – Children who have ADD/ADHD can be marvelously creative and imaginative. The child who daydreams and has ten different thoughts at once can become a master problem-solver, a fountain of ideas, or an inventive artist. Children with ADD/ADHD may be easily distracted, but sometimes they notice what others don’t see.
• Flexibility – Because children with ADD/ADHD consider a lot of options at once, they don’t become set on one alternative early on and are more open to different ideas.
• Enthusiasm and spontaneity – Children with ADD/ADHD are rarely boring! They’re interested in a lot of different things and have lively personalities. In short, if they’re not exasperating you (and sometimes even when they are), they’re a lot of fun to be with.
• Energy and drive – When kids with ADD/ADHD are motivated, they work or play hard and strive to succeed. It actually may be difficult to distract them from a task that interests them, especially if the activity is interactive or hands-on.

Keep in mind, too, that ADD/ADHD has nothing to do with intelligence or talent. Many children with ADD/ADHD are intellectually or artistically gifted.

Helping a child with ADD / ADHD

Whether or not your child’s symptoms of inattention, hyperactivity, and impulsivity are due to ADD/ADHD, they can cause many problems if left untreated. Children who can’t focus and control themselves may struggle in school, get into frequent trouble, and find it hard to get along with others or make friends. These frustrations and difficulties can lead to low self-esteem as well as friction and stress for the whole family.
But treatment can make a dramatic difference in your child’s symptoms. With the right support, your child can get on track for success in all areas of life.

Don’t wait to get help for your child

If your child struggles with symptoms that look like ADD/ADHD, don’t wait to seek professional help. You can treat your child’s symptoms of hyperactivity, inattention, and impulsivity without having a diagnosis of attention deficit disorder.
Options to start with include getting your child into therapy, implementing a better diet and exercise plan, and modifying the home environment to minimize distractions.
If you do receive a diagnosis of ADD/ADHD, you can then work with your child’s doctor, therapist, and school to make a personalized treatment plan that meets his or her specific needs. Effective treatment for childhood ADD/ADHD involves behavioral therapy, parent education and training, social support, and assistance at school. Medication may also be used, however, it should never be the sole attention deficit disorder treatment.

Parenting tips for children with ADD / ADHD

If your child is hyperactive, inattentive, or impulsive, it may take a lot of energy to get him or her to listen, finish a task, or sit still. The constant monitoring can be frustrating and exhausting. Sometimes you may feel like your child is running the show. But there are steps you can take to regain control of the situation, while simultaneously helping your child make the most of his or her abilities.
While attention deficit disorder is not caused by bad parenting, there are effective parenting strategies that can go a long way to correct problem behaviors.
Children with ADD/ADHD need structure, consistency, clear communication, and rewards and consequences for their behavior. They also need lots of love, support, and encouragement.
There are many things parents can do to reduce the signs and symptoms of ADD/ADHD without sacrificing the natural energy, playfulness, and sense of wonder unique in every child.

School tips for children with ADD / ADHD

ADD/ADHD, obviously, gets in the way of learning. You can’t absorb information or get your work done if you’re running around the classroom or zoning out on what you’re supposed to be reading or listening to.
Think of what the school setting requires children to do: Sit still. Listen quietly. Pay attention. Follow instructions. Concentrate. These are the very things kids with ADD/ADHD have a hard time doing—not because they aren’t willing, but because their brains won’t let them.
But that doesn’t mean kids with ADD/ADHD can’t succeed at school. There are many things both parents and teachers can do to help children with ADD/ADHD thrive in the classroom. It starts with evaluating each child’s individual weaknesses and strengths, then coming up with creative strategies for helping the child focus, stay on task, and learn to his or her full capability, 

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The Mental Health Benefits of Exercise

The Exercise Prescription for Depression, Anxiety, Stress, and More

In This ArticleEveryone knows that regular exercise is good for the body. But exercise is also one of the most effective ways to improve your mental health. Regular exercise can have a profoundly positive impact on depression, anxiety, ADHD, and more. It also relieves stress, improves memory, helps you sleep better, and boosts overall mood. And you don’t have to be a fitness fanatic to reap the benefits. Research indicates that modest amounts of exercise can make a difference. No matter your age or fitness level, you can learn to use exercise as a powerful tool to feel better.

What are the mental health benefits of exercise?

Exercise is not just about aerobic capacity and muscle size. Sure, exercise can improve your physical health and your physique, trim your waistline, improve your sex life, and even add years to your life. But that’s not what motivates most people to stay active.
People who exercise regularly tend to do so because it gives them an enormous sense of well-being. They feel more energetic throughout the day, sleep better at night, have sharper memories, and feel more relaxed and positive about themselves and their lives. And it’s also powerful medicine for many common mental health challenges.

Exercise and depression

Studies show that exercise can treat mild to moderate depression as effectively as antidepressant medication—but without the side-effects, of course. In addition to relieving depression symptoms, research also shows that maintaining an exercise schedule can prevent you from relapsing.
Exercise is a powerful depression fighter for several reasons. Most importantly, it promotes all kinds of changes in the brain, including neural growth, reduced inflammation, and new activity patterns that promote feelings of calm and well-being. It also releases endorphins, powerful chemicals in your brain that energize your spirits and make you feel good. Finally, exercise can also serve as a distraction, allowing you to find some quiet time to break out of the cycle of negative thoughts that feed depression.

Exercise and anxiety

Exercise is a natural and effective anti-anxiety treatment. It relieves tension and stress, boosts physical and mental energy, and enhances well-being through the release of endorphins. Anything that gets you moving can help, but you’ll get a bigger benefit if you pay attention instead of zoning out.
Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin. By adding this mindfulness element—really focusing on your body and how it feels as you exercise—you’ll not only improve your physical condition faster, but you may also be able to interrupt the flow of constant worries running through your head.

Exercise and stress

Ever noticed how your body feels when you’re under stress? Your muscles may be tense, especially in your face, neck, and shoulders, leaving you with back or neck pain, or painful headaches. You may feel a tightness in your chest, a pounding pulse, or muscle cramps. You may also experience problems such as insomnia, heartburn, stomachache, diarrhea, or frequent urination. The worry and discomfort of all these physical symptoms can in turn lead to even more stress, creating a vicious cycle between your mind and body.
Exercising is an effective way to break this cycle. As well as releasing endorphins in the brain, physical activity helps to relax the muscles and relieve tension in the body. Since the body and mind are so closely linked, when your body feels better so, too, will your mind.

Exercise and ADHD

Exercising regularly is one of the easiest and most effective ways to reduce the symptoms of ADHD and improve concentration, motivation, memory, and mood. Physical activity immediately boosts the brain’s dopamine, norepinephrine, and serotonin levels—all of which affect focus and attention. In this way, exercise works in much the same way as ADHD medications such as Ritalin and Adderall.

Exercise and PTSD and trauma

Evidence suggests that by really focusing on your body and how it feels as you exercise, you can actually help your nervous system become “unstuck” and begin to move out of the immobilization stress response that characterizes PTSD or trauma. Instead of thinking about other things, pay close attention to the physical sensations in your joints and muscles, even your insides as your body moves. Exercises that involve cross movement and that  engage both arms and legs—such as walking (especially in sand), running, swimming, weight training, or dancing—are some of your best choices.
Outdoor activities like hiking, sailing, mountain biking, rock climbing, whitewater rafting, and skiing (downhill and cross-country) have also been shown to reduce the symptoms of PTSD.

Other mental and emotional benefits of exercise

• Sharper memory and thinking. The same endorphins that make you feel better also help you concentrate and feel mentally sharp for tasks at hand. Exercise also stimulates the growth of new brain cells and helps prevent age-related decline.
• Higher self-esteem. Regular activity is an investment in your mind, body, and soul. When it becomes habit, it can foster your sense of self-worth and make you feel strong and powerful. You’ll feel better about your appearance and, by meeting even small exercise goals, you’ll feel a sense of achievement.
• Better sleep. Even short bursts of exercise in the morning or afternoon can help regulate your sleep patterns. If you prefer to exercise at night, relaxing exercises such as yoga or gentle stretching can help promote sleep.
• More energy. Increasing your heart rate several times a week will give you more get-up-and-go. Start off with just a few minutes of exercise a day, and increase your workout as you feel more energized.
• Stronger resilience. When faced with mental or emotional challenges in life, exercise can help you cope in a healthy way, instead of resorting to alcohol, drugs, or other negative behaviors that ultimately only make your symptoms worse. Regular exercise can also help boost your immune system and reduce the impact of stress.

Reaping the mental health benefits of exercise is easier than you think

Wondering just how active you need to be to get a mental health boost? It’s probably not as much as you think. You don’t need to devote hours out your busy day, train at the gym, sweat buckets, or run mile after monotonous mile. You can reap all the physical and mental health benefits of exercise with 30-minutes of moderate exercise five times a week. Two 15-minute or even three 10-minute exercise sessions can also work just as well.

Even a little bit of activity is better than nothing

If that still seems intimidating, don’t despair. Even just a few minutes of physical activity are better than none at all. If you don’t have time for 15 or 30 minutes of exercise, or if your body tells you to take a break after 5 or 10 minutes, for example, that’s okay, too. Start with 5- or 10-minute sessions and slowly increase your time. The more you exercise, the more energy you’ll have, so eventually you’ll feel ready for a little more. The key is to commit to do some moderate physical activity—however little—on most days. As exercising becomes habit, you can slowly add extra minutes or try different types of activities. If you keep at it, the benefits of exercise will begin to pay off.

You don't have to suffer to get results

Research shows that moderate levels of exercise are best for most people. Moderate means:

1. That you breathe a little heavier than normal, but are not out of breath.  For example, you should be able to chat with your walking partner, but not easily sing a song.
2. That your body feels warmer as you move, but not overheated or very sweaty.

Overcoming mental health obstacles to exercise

So now you know that exercise will help you feel much better and that it doesn’t take as much effort as you might have thought. But taking that first step is still easier said than done. Exercise obstacles are very real—particularly when you’re also struggling with mental health. Here are some common barriers and what you can do to get past them.

• Feeling exhausted. When you’re tired or stressed, it feels like working out will just make it worse. But the truth is that physical activity is a powerful energizer. Studies show that regular exercise can dramatically reduce fatigue and increase your energy levels. If you are really feeling tired, promise yourself a 5-minute walk. Chances are you’ll be able to go five more minutes.
• Feeling overwhelmed. When you’re stressed or depressed, the thought of adding another obligation can seem overwhelming. Working out just doesn’t seem doable. If you have children, managing childcare while you exercise can be a big hurdle. Just remember that physical activity helps us do everything else better. If you begin thinking of physical activity as a priority, you will soon find ways to fit small amounts in a busy schedule.  
• Feeling hopeless. Even if you’re starting at “ground zero,” you can still workout. Exercise helps you get in shape. If you have no experience exercising, start slow with low-impact movement a few minutes each day.
• Feeling pain. If you have a disability, severe weight problem, arthritis, or any injury or illness that limits your mobility, talk to your healthcare provider about ways to safely exercise. You shouldn’t ignore pain, but rather do what you can, when you can. Divide your exercise into shorter, more frequent chunks of time if that helps, or try exercising in water to reduce joint or muscle discomfort.    
• Feeling bad about yourself. Are you your own worst critc? It’s time to try a new way of thinking about your body. No matter what your weight, age or fitness level, there are others like you with the goals of getting fit. Try surrounding yourself with people in your shoes. Take a class with people at a variety of fitness levels. Accomplishing even the smallest fitness goals will help you gain body confidence.

Getting started exercising when you’re anxious or depressed

Many of us find it hard enough to motivate ourselves to exercise at the best of times. When we feel depressed, anxious, stressed or have other mental or emotional problems, it can be doubly difficult. This is especially true of depression and anxiety, and it can leave you feeling trapped in a catch-22 situation. You know exercise will make you feel better, but depression has robbed you of the energy and motivation you need to exercise, or your social anxiety means you can’t bear the thought of being seen at an exercise class or running through the park. So what can you do?

It's okay to start small. In fact, it's smart.

When you’re under the cloud of an emotional disorder and haven’t exercised for a long time, setting yourself extravagant goals like completing a marathon or working out for an hour every morning will only leave you more despondent if you fall short. Better to set yourself achievable goals and build up from there.

Schedule your workout at the time of day when your energy is highest

That may be first thing in the morning before work or school, or at lunchtime before the mid-afternoon lull hits. If depression or anxiety has you feeling tired and unmotivated all day long, try dancing to some music or simply going for a walk. Even a short, 15-minute walk can help clear your mind, improve your mood, and boost your energy level. As you move and start to feel a little better, you’ll experience a greater sense of control over your well-being. You may even feel energized enough to exercise more vigorously—by walking further, breaking into a run, or adding a bike ride, for example.

Other tips for staying motivated when you’re also struggling with mental health

• Focus on activities you enjoy. Any activity that gets you moving counts. That could include throwing a Frisbee with a dog or friend, walking laps of a mall window shopping, or cycling to the grocery store. If you’ve never exercised before or don’t know what you might enjoy, try a few different things. Activities such as gardening or tackling a home improvement project can be great ways to start moving more when you have a mood disorder—as well as helping you become more active, they can also leave you with a sense of purpose and accomplishment.
• Be comfortable. Whatever time of day you decide to exercise, wear clothing that’s comfortable and choose a setting that you find calming or energizing. That may be a quiet corner of your home, a scenic path, or your favorite city park.
• Reward yourself. Part of the reward of completing an activity is how much better you’ll feel afterwards, but it always helps your motivation to promise yourself an extra treat for exercising. Reward yourself with a hot bubble bath after a workout, a delicious smoothie, or with an extra episode of your favorite TV show.
• Make exercise a social activity. Exercising with a friend or loved one, or even your kids will not only make exercising more fun and enjoyable, it can also help to motivate you to stick to a workout routine. You’ll also feel better than exercising alone. In fact, when you’re suffering from a mood disorder such as depression, the companionship can be just as important as the exercise.

Easy ways to move more that don't involve the gym

Don’t have 30 minutes to dedicate to yoga or a bike ride? Don’t worry. Think about physical activity as a lifestyle rather than just a single task to check off. Look at your daily routine and consider ways to sneak in activity here, there, and everywhere. Need ideas? We’ve got them.

• In and around your home. Clean the house, wash the car, tend to the yard and garden, mow the lawn with a push mower, sweep the sidewalk or patio with a broom.
• At work and on the go. Bike or walk to an appointment rather than drive, banish all elevators and get to know every staircase possible, briskly walk to the bus stop then get off one stop early, park at the back of the lot and walk into the store or office, take a vigorous walk during your coffee break.
• With the family. Jog around the soccer field during your kid’s practice, make a neighborhood bike ride part of weekend routine, play tag with your children in the yard, go canoeing at a lake, walk the dog in a new place.
• Just for fun. Pick fruit at an orchard, boogie to music, go to the beach or take a hike, gently stretch while watching television, organize an office bowling team, take a class in martial arts, dance, or yoga.

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Anxiety Disorders and Anxiety Attacks

Signs, Symptoms, and Treatment Options

In This ArticleIt’s normal to feel anxious when facing a challenging situation, such as a job interview, a tough exam, or a blind date. But if your worries and fears seem overwhelming and interfere with your daily life, you may be suffering from an anxiety disorder. There are many different types of anxiety disorders—and many effective treatments and self-help strategies. Once you understand your anxiety disorder, there are steps you can take to reduce your symptoms and regain control of your life.

Understanding anxiety disorders

Anxiety is the body’s natural response to danger, an automatic alarm that goes off when you feel threatened, under pressure, or are facing a stressful situation.
In moderation, anxiety isn’t always a bad thing. In fact, anxiety can help you stay alert and focused, spur you to action, and motivate you to solve problems. But when anxiety is constant or overwhelming, when it interferes with your relationships and activities, it stops being functional—that’s when you’ve crossed the line from normal, productive anxiety into the territory of anxiety disorders.

Do your symptoms indicate an anxiety disorder?

If you identify with several of the following signs and symptoms, and they just won’t go away, you may be suffering from an anxiety disorder:

• Are you constantly tense, worried, or on edge?
• Does your anxiety interfere with your work, school, or family responsibilities?
• Are you plagued by fears that you know are irrational, but can’t shake?
• Do you believe that something bad will happen if certain things aren’t done a certain way?
• Do you avoid everyday situations or activities because they cause you anxiety?
• Do you experience sudden, unexpected attacks of heart-pounding panic?
• Do you feel like danger and catastrophe are around every corner?

Signs and symptoms of anxiety disorders

Because anxiety disorders are a group of related conditions rather than a single disorder, they can look very different from person to person. One individual may suffer from intense anxiety attacks that strike without warning, while another gets panicky at the thought of mingling at a party. Someone else may struggle with a disabling fear of driving, or uncontrollable, intrusive thoughts. Yet another may live in a constant state of tension, worrying about anything and everything.
Despite their different forms, all anxiety disorders share one major symptom: persistent or severe fear or worry in situations where most people wouldn’t feel threatened.

Emotional symptoms of anxiety

In addition to the primary symptoms of irrational and excessive fear and worry, other common emotional symptoms of anxiety include:

Feelings of apprehension or dread Trouble concentrating Feeling tense and jumpy Anticipating the worst Irritability Restlessness Watching for signs of danger Feeling like your mind’s gone blank

Physical symptoms of anxiety

Anxiety is more than just a feeling. As a product of the body’s fight-or-flight response, anxiety involves a wide range of physical symptoms. Because of the numerous physical symptoms, anxiety sufferers often mistake their disorder for a medical illness. They may visit many doctors and make numerous trips to the hospital before their anxiety disorder is discovered.
Common physical symptoms of anxiety include:

Pounding heart Sweating Stomach upset or dizziness Frequent urination or diarrhea Shortness of breath Tremors and twitches Muscle tension Headaches Fatigue Insomnia

The link between anxiety symptoms and depression

Many people with anxiety disorders also suffer from depression at some point. Anxiety and depression are believed to stem from the same biological vulnerability, which may explain why they so often go hand-in-hand. Since depression makes anxiety worse (and vice versa), it’s important to seek treatment for both conditions.

Anxiety attacks and their symptoms

Anxiety attacks, also known as panic attacks, are episodes of intense panic or fear. Anxiety attacks usually occur suddenly and without warning. Sometimes there’s an obvious trigger—getting stuck in an elevator, for example, or thinking about the big speech you have to give—but in other cases, the attacks come out of the blue.
Anxiety attacks usually peak within 10 minutes, and they rarely last more than 30 minutes. But during that short time, the terror can be so severe that you feel as if you’re about to die or totally lose control. The physical symptoms of anxiety attacks are themselves so frightening that many people believe they’re having a heart attack. After an anxiety attack is over, you may be worried about having another one, particularly in a public place where help isn’t available or you can’t easily escape.

Symptoms of anxiety attacks include:

Surge of overwhelming panic Feeling of losing control or going crazy Heart palpitations or chest pain Feeling like you’re going to pass out Trouble breathing or choking sensation Hyperventilation Hot flashes or chills Trembling or shaking Nausea or stomach cramps Feeling detached or unreal

Types of anxiety disorders

There are six major types of anxiety disorders, each with their own distinct symptom profile: generalized anxiety disorder, obsessive-compulsive disorder, panic disorder (anxiety attacks), phobia, post-traumatic stress disorder, and social anxiety disorder.

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Depression

What is depression?

Sadness or downswings in mood are normal reactions to life’s struggles, setbacks, and disappointments. Many people use the word “depression” to explain these kinds of feelings, but depression is much more than just sadness.

Some people describe depression as “living in a black hole” or having a feeling of impending doom. However, some depressed people don't feel sad at all—they may feel lifeless, empty, and apathetic, or men in particular may even feel angry, aggressive, and restless.

Whatever the symptoms, depression is different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun. The feelings of helplessness, hopelessness, and worthlessness are intense and unrelenting, with little, if any, relief.

Are you depressed?

If you identify with several of the following signs and symptoms—especially the first two—and they just won’t go away, you may be suffering from depression.

• you feel hopeless and helpless
• you’ve lost interest in friends, activities, and things you used to enjoy
• you feel tired all the time
• your sleep and appetite has changed
• you can’t concentrate or find that previously easy tasks are now difficult
• you can’t control your negative thoughts, no matter how much you try
• you are much more irritable, short-tempered, or aggressive than usual
• you’re consuming more alcohol than normal or engaging in other reckless behavior

What are the signs and symptoms of depression?

Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted—the more likely it is that you’re dealing with depression. When these symptoms are overwhelming and disabling, that's when it's time to seek help.

Signs and symptoms of depression include:

• Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
• Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
• Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
• Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).
• Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
• Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
• Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
• Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
• Concentration problems. Trouble focusing, making decisions, or remembering things.
• Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

Depression and suicide risk

Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and learn to recognize the warning signs.

Warning signs of suicide include:

• Talking about killing or harming one’s self
• Expressing strong feelings of hopelessness or being trapped
• An unusual preoccupation with death or dying
• Acting recklessly, as if they have a death wish (e.g. speeding through red lights)
• Calling or visiting people to say goodbye
• Getting affairs in order (giving away prized possessions, tying up loose ends)
• Saying things like “Everyone would be better off without me” or “I want out”
• A sudden switch from being extremely depressed to acting calm and happy

If You Are Feeling Suicidal...

When you’re feeling extremely depressed or suicidal, your problems don’t seem temporary—they seem overwhelming and permanent. But with time, you will feel better, especially if you reach out for help. If you are feeling suicidal, know that there are many people who want to support you during this difficult time, so please reach out for help!
Read Suicide Help or call 1-800-273-TALK in the U.S. or visit IASP or Suicide.org to find a helpline in your country.

If Someone You Love is Suicidal...

If you think a friend or family member is considering suicide, express your concern and seek professional help immediately. Talking openly about suicidal thoughts and feelings can save a life!
Read Suicide Prevention.

The different faces of depression

Depression often looks different in men and women, and in young people and older adults. An awareness of these differences helps ensure that the problem is recognized and treated.

Depression in men

Depression is a loaded word in our culture. Many associate it, however wrongly, with a sign of weakness and excessive emotion. This is especially true with men. Depressed men are less likely than women to acknowledge feelings of self-loathing and hopelessness. Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies. Other signs and symptoms of depression in men include anger, aggression, violence, reckless behavior, and substance abuse. Even though depression rates for women are twice as high as those in men, men are a higher suicide risk, especially older men. Learn more.

Depression in women

Rates of depression in women are twice as high as they are in men. This is due in part to hormonal factors, particularly when it comes to premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), postpartum depression, and perimenopausal depression. As for signs and symptoms, women are more likely than men to experience pronounced feelings of guilt, sleep excessively, overeat, and gain weight. Women are also more likely to suffer from seasonal affective disorder. Learn more.

Depression in teens

While some depressed teens appear sad, others do not. In fact, irritability—rather than depression—is frequently the predominant symptom in depressed adolescents and teens. A depressed teenager may be hostile, grumpy, or easily lose his or her temper. Unexplained aches and pains are also common symptoms of depression in young people.

Left untreated, teen depression can lead to problems at home and school, drug abuse, self-loathing—even irreversible tragedy such as homicidal violence or suicide. But with help, teenage depression is highly treatable. Learn more.

Depression in older adults

The difficult changes that many older adults face—such as bereavement, loss of independence, and health problems—can lead to depression, especially in those without a strong support system. However, depression is not a normal part of aging. Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression, and so the problem often goes unrecognized. Depression in older adults is associated with poor health, a high mortality rate, and an increased risk of suicide, so diagnosis and treatment are extremely important. Learn more.

Postpartum depression

Many new mothers suffer from some fleeting form of the “baby blues.” Postpartum depression, in contrast, is a longer lasting and more serious depression triggered, in part, by hormonal changes associated with having a baby. Postpartum depression usually develops soon after delivery, but any depression that occurs within six months of childbirth may be postpartum depression. Learn more.

What are the types of depression?

Depression comes in many shapes and forms. The different types of depression have unique symptoms, causes, and effects. Knowing what type of depression you have can help you manage your symptoms and get the most effective treatment.

Major depression

Major depression is characterized by the inability to enjoy life and experience pleasure. The symptoms are constant, ranging from moderate to severe. Left untreated, major depression typically lasts for about six months. Some people experience just a single depressive episode in their lifetime, but more commonly, major depression is a recurring disorder. However, there are many things you can do to support your mood and reduce the risk of recurrence.

Dysthymia (recurrent, mild depression)

Dysthmia is a type of chronic “low-grade” depression. More days than not, you feel mildly or moderately depressed, although you may have brief periods of normal mood. The symptoms of dysthymia are not as strong as the symptoms of major depression, but they last a long time (at least two years). These chronic symptoms make it very difficult to live life to the fullest or to remember better times. Some people also experience major depressive episodes on top of dysthymia, a condition known as “double depression.” If you suffer from dysthymia, you may feel like you’ve always been depressed. Or you may think that your continuous low mood is “just the way you are.” However, dysthymia can be treated, even if your symptoms have gone unrecognized or untreated for years.

Bipolar Disorder: When Depression is Just One Side of the Coin

Bipolar disorder, also known as manic depression, is characterized by cycling mood changes. Episodes of depression alternate with manic episodes, which can include impulsive behavior, hyperactivity, rapid speech, and little to no sleep. Typically, the switch from one mood extreme to the other is gradual, with each manic or depressive episode lasting for at least several weeks. When depressed, a person with bipolar disorder exhibits the usual symptoms of major depression. However, the treatments for bipolar depression are very different. In fact, antidepressants can make bipolar depression worse.

Seasonal affective disorder (SAD): When winter brings the blues

While the onset of winter can cause many of us to experience a drop in mood, some people actually develop seasonal depression, otherwise known as seasonal affective disorder (SAD). SAD can make you feel like a completely different person to who you are in the summer: hopeless, sad, tense, or stressed, with no interest in friends or activities you normally love. While a less common form of the disorder causes depression during the summer months, SAD usually begins in fall or winter when the days become shorter and remains until the brighter days of spring or early summer. For more, seeSeasonal Affective Disorder (SAD).

Depression causes and risk factors

Some illnesses have a specific medical cause, making treatment straightforward. If you have Type-1 diabetes, you take insulin. If you have appendicitis, you have surgery. Depression, however, is more complicated. Depression is not just the result of a chemical imbalance in the brain, and it’s not simply cured with medication. Experts believe that depression is caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much—if not more so—than genetics. However, certain risk factors make you more vulnerable to depression.

Causes and risk factors for depression

• Loneliness
• Lack of social support
• Recent stressful life experiences
• Family history of depression
• Marital or relationship problems
• Financial strain
• Early childhood trauma or abuse
• Alcohol or drug abuse
• Unemployment or underemployment
• Health problems or chronic pain

The cause of your depression helps determine the treatment

Understanding the underlying cause of your depression may help you overcome the problem. For example, if you are depressed because of a dead end job, the best treatment might be finding a more satisfying career, not taking an antidepressant. If you are new to an area and feeling lonely and sad, finding new friends at work or through a hobby will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation.

The road to depression recovery

Just as the symptoms and causes of depression are different in different people, so are the ways to feel better. What works for one person might not work for another, and no one treatment is appropriate in all cases. If you recognize the signs of depression in yourself or a loved one, take some time to explore the many treatment options. In most cases, the best approach involves a combination of social support, lifestyle changes, emotional skills building, and professional help.

Ask for help and support

If even the thought of tackling your depression seems overwhelming, don’t panic. Feeling helpless and hopeless is a symptom of depression—not the reality of your situation. It does not mean that you’re weak or you can’t change! The key to depression recovery is to start small and ask for help. The simple act of talking to someone face to face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you; he or she just needs to be a good listener.

Having a strong support system will speed your recovery. Isolation fuels depression, so reach out to others, even if you feel like being alone or don’t want to feel like a burden to others. The truth is that most people will be happy that you chose to confide in them; they’ll be flattered that you trust them enough to open up. So, let your family and friends know what you’re going through and how they can support you.

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