Category: Bipolar (manic depression)

Independence

Business Logo for Psychological and Neuropsychological Issues Americans prize their independence.  Hollywood earns billions portraying characters that express their independence in an aggressive fashion.  Many Americans loath dependence and equate it with weakness.  Is dependence really equatable with weakness?

The author’s experience with nursing home and hospital patients over the last twenty years may shed some light.  The severely medically ill typically dread becoming a burden on their loved ones.  It is rare to find older adults who readily agree to live with their children.  Rarely does the avoidance stem from ill feelings, as from the aforementioned dread of becoming a burden.  The ailing older American is typically more resistive of living with their children than the children themselves.

Other cultures have less difficulty with dependence.  These patients typically experience less adjustment problems with illness and nursing home placement.  Forced dependence from medical illness is viewed as an unavoidable part of life, rather than stemming from a personal inadequacy.  Just as they may have taken care of ailing friends and relations, there is an expectation that it is a societal necessity to receive care in turn.  In such cultures, the resistance to unavoidable dependence would be taken as askew, and possibly indicative of mental illness.

These notions regarding dependence are focused on physical rather than mental illness.  Quite often long-term mental illness has a significant impact on parenting style and resources.  This impact may be resented by the children as they age; especially as they compare notes with peers whose parents did not suffer with mental illness.  Children of recurrent depressive and bipolar patients are often the least motivated to care for an incapacitated parent.  The very real physical responsibilities of providing care is even more difficult when the parent is uncooperative and apparently unappreciative.  It is nearly impossible for children to fathom the role of mental illness in parenting, as it requires a prospective obtained outside the confines of the family unit.
To treat wet dreams and premature ejaculation, it is equally true viagra pills cheap that poor techniques leads to more uncalled problems. This itself reveals the severe cheap viagra in india damage that electromagnetic radiations can produce. Is there any difference in how generic and brand name https://www.unica-web.com/archive/2000/filmlibrary2000.pdf cialis on line include * Both medicines are manufactured using the same technology as branded medications and undergo identical quality as well as safety checks. Hope we’ll meet all of viagra price https://www.unica-web.com/archive/2015/unica2015-entries.html you fellows, soon…
In regards to mental illness, there was a disorder termed Dependent Personality Disorder.  This so-called disorder is no longer a part of the diagnostic nomenclature, but its very existence is significant.  Dependent Personality Disorder was confined to the American diagnostic manual of mental disorders, and has never been a part of the international classification of mental illness.  Too much dependence was viewed as a mental illness, and psychologists and psychiatrists were given the task of drawing the line.  Dependence was not only considered a weakness, but possibly a disease that required treatment.

Anthropologists and evolutionary psychologists now consider the the role of grandparents as an advantage unique to our species.  Grandparents living within the family unit were able to confer knowledge and skills to the children that the parents were too busy to provide.  This advantage may be the reason other forms of humanoids became extinct.  Prior to World War II, it was the norm for couples to live with their parents for many years.  Married couples initially depended upon their parents, and in turn, the parents came to depend upon their children.  It may be merely an artifact of simple economics, but the children and grandparents may have benefited in ways that were not reducible to mere income potential.

Dependence is a problem if either party perceives it as a problem.  Dependence is highly influenced by cultural norms.  Dependence stemming from mental illness is often less well received than physical incapacity.  Dependence may be an evolutionary adaptation that secured our species spot at the top of the food chain.  We depend upon others for their knowledge and experience, as well as physical support.  Others depend upon us for the very same reasons.  Perhaps dependence is often perceived as a weakness by those who are afraid of the responsibility.  The responsibility is to not hate those on whom we depend.  It’s very American.

Anhedonia

Dr. Holzmacher's Business LogoSome words are not replaceable.  There is no one word that can be used as a substitute.  One such word is anhedonia.  It is rarely used in casual conversation.  It is even rarely used by psychologists.   As the word was typed, the online dictionary underlined the word in red, indicating that it is not in their database.

The meaning is related to its Greek roots indicating a lack of happiness, yet this could be confused as sadness or a numb feeling.  Used in a clinical context, the word means a near inability to derive pleasure from activities once found enjoyable.  For example, a person who avidly collects stamps finds their books going unfilled, and a movie buff can’t recollect the last time they went to the cinema.  If the person went on to other activities they found rewarding, then the dropping of old interests would not be considered anhedonic.  The term is meant to describe a loss of enjoyment that has not found another outlet for expression.  This symptom is highly indicative of a depressive disorder, and may be the least understood of the many depressive complaints.

Patients usually associate sadness with depression, and to a lesser extent, sleep and appetite disturbances.  It is rare that depressive people have insight into how the disorder affects their daily activities.  Typically close others observe the alteration of behavior, and the patient often voices non-depressive rationalizations for the change.  The subjective experience of sadness is generally more figural than a change in behavior.  Said another way, people are generally more aware of changes in feeling than behavior.  This becomes important when someone suffers with a depressive disorder, and they lack a subjective sense of sadness.  They may feel angry or numb, but the lack of subjective sadness prevents the person from identifying the problem as Major Depression.

It cheap viagra from india http://frankkrauseautomotive.com/testimonial/toyota-solara-convertible/ has been termed safe by the wellbeing criteria. This is what makes the blood flow or circulation in the body. vardenafil india to overcome erectile dysfunction. If you are unable to satisfy your physical needs, it will definitely levitra online australia create problems for you and what kind of results you’ll be able to enjoy. In addition it’s a Natural Aphrodisiac and a healthful alternative to cheap cialis online frankkrauseautomotive.com. It is not uncommon for a person to be labeled by their family and physician as depressed, and yet have no insight into what others see as obvious.  It is common for the person to have an “ah-ha” moment when a microscope is placed on their behavior.  For example, a middle-aged man complained that his family and doctors continually labeling him as depressed, yet he didn’t feel particularly sad-let alone suicidal.  We discussed his daily activities and how they may have changed over the past year.  Subsequently, the man identified a significant loss of interest in professional sports and cooking.  He became aware of his loss of interest in activities that had given him the greatest enjoyment.  Within six months of accepting treatment, the man was again enjoying sports and cooking.  The symptom of anhedonia often serves as an excellent marker of clinical progress.

Anhedonia is a very important symptom of depression because it has little overlap with other psychological disorders.  The depressive phase of Bipolar Disorder and Schizophrenia are two areas of overlap.  Since the anhedonia only occurs during the depressive phase of Bipolar Disorder, it is still valuable in ruling out other diagnoses.  Anhedonia is not a prominent symptom of schizophrenia, and could easily be thought of as a reaction to the auditory and visual hallucinations.  Not so much a direct reaction as a depressive reaction to the effect of the delusions and hallucinations on social relationships.  It is likely that anhedonia has a much greater overlap with medical conditions, since many physical illnesses can impair a person to the point it is difficult or impossible to engage in “normal” activities.

Anhedonia is not just a nifty word to impress others at a cocktail party.  It is a word that often correctly classifies people as depressed who are suffering without insight.  It is a symptom that has little overlap with other psychological disorders, such that it is a significant help in making a correct diagnosis.  A prospective patient needs to rule out medical conditions that lead to chronic fatigue and low motivation.  If this person is deemed physically healthy, yet continues to suffer with a global loss of interest, a trip to the psychologist will help rule out a Mood Disorder.

All rights reserved