February 7, 2017

By Allan D. Lieberman, M.D.

These are some of the many case histories of successful treatment of behavior disorders in children and adults. All of our patients are treated with an individualized, comprehensive program.

Case 1: This patient came to us when she was 4 years old. Her behavior could be described as “the Attention Fatigue Syndrome”, meaning she would appear very hyperactive and not able to focus one minute, and the next she would be whiney or crying with fatigue.

She also had allergic rhinitis, with runny nose and dark circles under her eyes and other classic allergy symptoms.

As we read through her medical history, we saw that she had often had ear infections and had been on many antibiotics. It was also documented that she had developed thrush and even vaginitis (infection of the female reproductive tract) as an infant and toddler, most probably as a side effect of all the antibiotics given for her ear infections. Based on so many symptoms of yeast overgrowth, we emphasized eradicating the yeast overgrowth as part of her initial treatment. Since her history of yeast-related problems was so clear, we used a systemic anti-fungal drug.

At the first follow-up visit, the mother said her child’s behavior had been better from the very first day of treatment. Overall, her symptoms were 50 percent better. About 4 months later as we continued to monitor her progress, we again prescribed a different anti-fungal medication and again her behavior improved significantly.

I had just heard Dr. William Shaw’s lecture about his research into the correlation between yeast overgrowth and neurological and behavior disorders. So eventually we tested this child with the Organic Acids Test as recommended by Dr. Shaw and found high levels of four metabolites from yeast overgrowth and also high levels of a bacterial metabolite from bacterial overgrowth.

On the basis of this test, I prescribed an anti-fungal medication again and the child’s behavior improved so markedly that the mother commented she had had only one tantrum in several weeks, whereas she used to have several tantrums daily.

However, we did not wish to continue to treat this child (or any patient) with medications to control yeast overgrowth, so we knew we had to look further into her case.

We suspected she had developed a hypersensitivity to the yeast metabolites we had found on her laboratory testing and that allergy testing could be an important key to her further improvement. During allergy testing in our Center’s testing room, she developed symptoms of sneezing, runny nose, restlessness, itching, and stomach pains when we tested her with allergy extracts of yeasts. Her symptoms all improved when we reached a neutralizing dose. Seeing these symptoms provoked and then “turned off” was amazing to the parents, but we see this sort of thing in our allergy testing process quite often. This little girl continued doing well with a maintenance treatment program of allergy desensitization extracts, a probiotic supplement (a supplement to replenish the normal good gut bacteria that are often killed by antibiotics), and, equally important, dietary measures. Her behavior continued to further improve over time with this comprehensive program.

[NOTE: Yeast eradication can play a powerful and important role in alleviating behavior problems, but need not be continued for an extended period of time when all the other parts of our Center’s comprehensive programs are followed.]

Case 2: This 12-year-old boy came to us with a long history of truly severe behavioral problems. His medical and school history showed he had been diagnosed with hyperactivity and aggressive tendencies by age 3 and difficulties with learning and focusing by age 6.

He was placed on Ritalin in first grade, but developed migraine headaches. He repeated first grade, was placed on Tofranil and became very fatigued. A pediatric neurologist was consulted and different medications tried, all of which provoked side effects of various kinds. Medications were discontinued but his behavior was so bad he was on the verge of being thrown out of school.

He was referred to a child psychiatrist at age 9. His formal diagnoses by age 11 were Attention Deficit and Hyperactivity Disorder (ADHD), Obsessive Compulsive Disorder (OCD), and Dysthymia (a form of depression). High-dose Prozac (60 mg.) was prescribed. On this drug, he was somewhat better, but developed screaming tantrums in school, especially in spring and fall. By age 11, he was prescribed Zoloft, whereupon he developed more OCD behaviors. He was placed in a class for learning disabled children, with additional behavior modification instituted after school.

When this child came to our office for initial evaluation, he was still on Ritalin and Zoloft but was unable to sit still or stay in one room. He persisted in wandering all over the building while his mother tried to give his history to one of our physicians. She related that he had had many antibiotics as an infant due to recurrent ear infections. His favorite foods were milk, sugars, and chocolate. There was a family history of Bipolar disease. Our physical examination of this boy showed allergic rhinitis (runny nose), athlete’s foot and jock itch (fungus diseases of the skin), mouth ulcers, and nail biting.

We placed him in our Center’s allergy testing room (we have a separate room where restless children can go) and tested him for foods, pollens, and inhalants. These tests showed moderate reactivity so he was started on allergy desensitization. Due to the obvious symptoms of yeast overgrowth (athlete’s foot and jock itch), we also started him on medications to eliminate yeast and fungus. We strongly recommended that his diet be changed to eliminate sugars and milk products, since these foods feed yeast and were the things he craved the most and ate the most (probable signs of allergic addiction).

When we received the results of our laboratory testing a few weeks later, they showed he had elevated levels of mercury and low levels of the essential minerals magnesium and selenium, again specific imbalances that we were able to address.

At the first follow-up 6 weeks later, his mother reported her son’s behavior was 30 percent better. Because of such marked improvement, she had been able to taper him totally off Zoloft and down to one-half of his previous dose of Ritalin. Her son had brought home the best report card ever. He was obviously calmer and showed increased focus. Athlete’s foot and jock itch had been eliminated. His symptoms of runny nose, constipation, and headaches had also decreased.

At the 3-month mark after beginning treatment at our Center, his mother reported that her son was 60 percent better in both his behavior and his physical symptoms. She had tapered him totally off Ritalin.

He had brought home straight E’s (for Excellent) on his report card and had recently attended a summer camp! This young man was so dramatically changed in demeanor and behavior that it was hard to believe he was the same person. Since he was still craving sugars and having mild headaches, we recommended further allergy testing to uncover hidden food allergies. Other nutrients were added to his plan.

For this young man, a comprehensive evaluation and treatment program provided an almost incredible turn-around from a tragically dismal history to a promising future. It’s hard to describe how deeply satisfying it is for the parents, the child, and the physician alike to see what wonderful results are possible when an effective comprehensive program is developed and then carefully followed.

There have been many, many such success stories at The Center. We only wish more parents could learn that there are natural, effective treatments for overcoming ADHD and other behavioral and developmental problems in their children.

February 7, 2017
February 7, 2017

PANDAS, is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The term is used to describe a subset of children who have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette’s Syndrome, and in whom symptoms worsen following strep infections such as “Strep throat” and Scarlet Fever.

The symptoms are usually dramatic, happen “overnight and out of the blue,” and can include motor and/or vocal tics, obsessions, and/or compulsions. In addition to these symptoms, children may also become moody, irritable, experience anxiety attacks, or show concerns about separating from parents or loved ones.

PANDAS was first discovered in 1998 by Dr. Susan Swedo during a Pediatric Obsessive Compulsive Disorder study when it was found some children’s OCD behaviors began shortly after a strep infection. In any autoimmune disease, it is the consequence of a misguided immune response against self-antigens by autoantibodies that results in the damage of specific organs. In the case of PANDAS, the child’s brain is being attacked.

In every bacterial infection, the body produces antibodies against the invading bacteria, and the antibodies help eliminate the bacteria from the body. However in Rheumatic Fever, the antibodies mistakenly recognize and “attack” the heart valves, joints, and/or certain parts of the brain. This phenomenon is called “molecular mimicry”, which means that proteins on the cell wall of the strep. bacteria are similar in some way to the proteins of the heart valve, joints, or brain. Because the antibodies set off an immune reaction which damages those tissues, the child with Rheumatic Fever can get heart disease (especially mitral valve regurgitation), arthritis, and/or abnormal movements known as Sydenham’s Chorea or St. Vitus Dance. In PANDAS, it is believed that something very similar to Sydenham’s Chorea occurs. One part of the brain that is affected in PANDAS is the Basal Ganglia, which is believed to be responsible for movement and behavior. Thus, the antibodies interact with the brain to cause tics and/or OCD, instead of Sydenham Chorea.

Causes

The strep bacteria is a very ancient organism which survives in its human host by hiding from the immune system as long as possible. It does this by putting molecules on its cell wall that look nearly identical to molecules found on the child’s heart, joints, skin, and brain tissues. This is called “molecular mimicry” and allows the strep bacteria to evade detection for a time.

However, the molecules on the strep bacteria are eventually recognized as foreign to the body and the child’s immune system reacts to them by producing antibodies. Because of the molecular mimicry, the antibodies react not only with the strep molecules, but also with the human host molecules that were mimicked.

The cross-reactive antibodies then trigger an immune reaction that “attacks” the mimicked molecules in the child’s own tissues. Studies show that some cross-reactive “anti-brain” antibodies target the brain, causing OCD, tics, and the other neuropsychiatric symptoms of PANDAS.

A leaky gut, whereby undigested proteins, pathogens, and toxins can pass into the bloodstream provoking inflammation and immune reaction generally underlies autoimmunity. It also makes absorption of nutrients difficult which adds to immune dysfunction. Over 70% of the immune system is in the gut.

Who is at risk?

ANDAS is a rare condition. It is believed that approximately one in 2,000 children are affected, though the diagnosis may be overlooked due to some of the common symptoms associated with the disease. In fact, there are some researchers who recommend including PANDAS in a category of other disorders which include similar neuropsychiatric symptoms called CANS (childhood acute neuropsychiatric symptoms) or PANS (pediatric acute-onset neuropsychiatric syndrome).

PANDAS is considered a pediatric disorder and typically first appears in childhood from age 3 to puberty. Reactions to strep infections are rare after age 12, but the investigators recognize that PANDAS could occur (rarely) among adolescents. It is unlikely that someone would experience these post-strep neuropsychiatric symptoms for the first time as an adult, but it has not been fully studied.

It is possible that adolescents and adults may have immune-mediated OCD, but this is not known

Symptoms

Children with PANDAS seem to have dramatic ups and downs in their OCD and/or tic severity. Tics or OCD which are almost always present at a relatively consistent level do not represent an episodic course. Many kids with OCD or tics have good days and bad days, or even good weeks and bad weeks. However, patients with PANDAS have a very sudden onset or worsening of their symptoms, followed by a slow, gradual improvement. If they get another strep infection, their symptoms suddenly worsen again. The increased symptom severity usually persists for at least several weeks, but may last for several months or longer. The tics or OCD then seem to gradually fade away, and the children often enjoy a few weeks or several months without problems. When they have another strep throat infection, the tics or OCD may return just as suddenly and dramatically as they did previously. Symptom onset includes Primary ONSET of OCD and/or Severe Anxiety along with at least two other following symptoms –

  • Obsessive compulsive disorder
  • Tics (motor and verbal)
  • Sensory Processing Disorder
  • ADD/ADHD
  • Age regression
  • Choreiform movements
  • Hyperactivity
  • Mood fluctuations
  • Changes in handwriting
  • Personality changes
  • Oppositional Defiant Disorder
  • Deterioration in math skills
  • Separation anxiety
  • Depression
  • Rages
  • Urinary incontinence, urgency and increased frequency (daytime or nighttime)
  • Anorexia

Treatment

Treatment options for children who are diagnosed with PANDAS are emerging.  The most common initial intervention is a combination of cognitive behavioral therapy (CBT), SSRI medications, antibiotics (with a minimum trial of 4-5 weeks), and supplements (such as vitamin D, Omega 3, and probiotics).  While some children may exhibit an improvement in symptoms when using antibiotics or SSRI medications, it is also often recommended to consult with a psychologist that is experienced in this area.

Often, the treatment protocol for PANDAS includes exposure and ritual prevention (ERP), which is a specific type of CBT. Using ERP, the psychologist helps the child to understand their obsessions, compulsions, and movements, how to challenge these symptoms as well as related anxiety. It is also important that the child learn specific therapeutic and stress management skills to practice in between sessions.  ERP is also used to lessen the probability and severity of future exacerbations.

doctor may prescribe penicillin, amoxicillin (Amoxil), azithromycin (Zithromax), or another antibiotic. For severe and refractory symptoms, the use of other treatments aimed at controlling the immune response have been studied and found to be effective. These include the use of intravenous immunoglobulin, steroids, and plasmapheresis (plasma exchange therapy in which blood is withdrawn from an individual and the liquid portion is removed and replaced and the blood is transfused back into the individual).

Alternative Treatment

  • N-acetyl cysteine/NAC has been found to help with some OCD symptoms.
  • Natural anti-inflammatories, such as Curcumin, can be also useful.
  • Natural antibiotics/anti-virals such as Olive Leaf Extract/OLE and Grapefruit Seed Extract/GSE.
  • Omega-3 supplements can support healthy brain function.
  • Using probiotics is very important to ensure optimum gut flora environments are not depleted during antibiotic treatments and for good overall immunity. As a precaution, avoid any that contain the streptococcus thermophilus strain.

Reference –

http://patient.info/doctor/pandas-paediatric-autoimmune-neuropsychiatric-disorder-associated-with-streptococcal-infection

http://www.pandasnetwork.org/SWEDOMRIstudy2000281%5B1%5D.pdf

http://www.adhd.com.au/PANDAS.htm

http://latitudes.org/dr-william-walsh-autism-ocd-pandas-depression-methylation/

http://www.chinatourmap.com/panda/diet.html

February 7, 2017

Obsessive-compulsive disorder is a mental illness. It’s made up of two parts: obsessions and compulsions. People may experience obsessions, compulsions, or both, and they cause a lot of distress –

  • Obsessions – Obsessions are unwelcome thoughts, images, urges or doubts that repeatedly appear in your mind; for example, thinking that you have been contaminated by dirt and germs, or experiencing a sudden urge to hurt someone. These obsessions are often frightening or seem so horrible that you can’t share them with others. The obsession interrupts your other thoughts and makes you feel very anxious.
  • Compulsions – Compulsions are repetitive activities that you feel you have to do. This could be something like repeatedly checking a door to make sure it is locked or repeating a specific phrase in your head to prevent harm coming to a loved one. The aim of a compulsion is to try and deal with the distress caused by the obsessive thoughts and relieve the anxiety you are feeling. However, the process of repeating these compulsions is often distressing and any relief you feel is often short-lived.

People who experience OCD usually know that obsessions and compulsions don’t make sense, but they still feel like they can’t control them. Obsessions and compulsions can also change over time.

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational—but even so, you feel unable to resist them and break free.

OCD presents itself in many guises, and certainly goes far beyond the common perception that OCD is merely hand washing or checking light switches. In general, OCD sufferers experience obsessions which take the form of persistent and uncontrollable thoughts, images, impulses, worries, fears or doubts. They are often intrusive, unwanted, disturbing, significantly interfere with the ability to function on a day-to-day basis as they are incredibly difficult to ignore. People with OCD often realise that their obsessional thoughts are irrational, but they believe the only way to relieve the anxiety caused by them is to perform compulsive behaviours, often to prevent perceived harm happening to themselves or, more often than not, to a loved one.

Most people with obsessive-compulsive disorder (OCD) fall into one of the following categories:

  • Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.
  • Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.
  • Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen, or they will be punished.
  • Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.
  • Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use.

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) is a type of OCD that occurs in childhood following the body’s reaction to infection. PANDAS looks very different from other forms of childhood OCD, the most obvious difference being that it happens very suddenly, with the child starting to have symptoms seemingly overnight, and has a very severe impact on the child’s life.

Causes

The brain is a very complex structure. It contains billions of nerve cells — called neurons — that must communicate and work together for the body to function normally. Neurons communicate via chemicals called neurotransmitters that stimulate the flow of information from one nerve cell to the next. At one time, it was thought that low levels of the neurotransmitter serotonin was responsible for the development of OCD. Now, however, scientists think that OCD arises from problems in the pathways of the brain that link areas dealing with judgment and planning with another area that filters messages involving body movements.

Who is at risk?

OCD can start at any time from preschool to adulthood. Although OCD can occur at any age, there are generally two age ranges when OCD tends to first appears –

  • Between the ages 8 and 12.
  • Between the late teen years and early adulthood.

Adults

  • Our best estimates are that about 1 in 100 adults — or between 2 to 3 million adults in the United States — currently have OCD.

Children

  • There are also at least 1 in 200 – or 500,000 – kids and teens that have OCD. This is about the same number of kids who have diabetes.
  • That means four or five kids with OCD are likely to be enrolled in any average size elementary school. In a medium to large high school, there could be 20 students struggling with the challenges caused by OCD.

Symptoms

Obsessions –

  • Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
  • The thoughts, impulses, or images are not simply excessive worries about real-life problems
  • The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
  • The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)

Compulsions

  • Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
  • The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
  • At some point during the course of the disorder, the adult has recognized that the obsessions or compulsions are excessive or unreasonable (not applicable to children).
  • The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships.
  • If another disorder is present, the content of the obsessions or compulsions is not restricted to it. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Treatment

Psychotherapy – A type of psychotherapy called cognitive behavior therapy is especially useful for treating OCD. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious or fearful without having obsessive thoughts or acting compulsively. One type of therapy called exposure and response prevention is especially helpful in reducing compulsive behaviors in OCD.

Medication – Doctors also may prescribe medication to help treat OCD. The most commonly prescribed medications for OCD are anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods.

Antidepressants are used to treat depression, but they are also particularly helpful for OCD, probably more so than anti-anxiety medications. They may take several weeks—10 to 12 weeks for some—to start working. Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time.

Alternative Treatment

Folate and folic acid, vitamin B12 – Studies suggest that folate deficiency, increased homocysteine, impaired metylation have been identified in depressive disorder. Recently, growing research has resulted in the biological association between obsessive-compulsive disorder and affective disorders. Therefore, in the present study it was evaluated whether or not folate and homocysteine levels changed. The B12 deficiency could be the consequence rather than the cause of OCD. Deficiencies of magnesium and the B vitamin folate have been linked to depression.

5HTP or 5-hydroxy-tryptophan –  L-tryptophan was found to be effective in reducing the symptoms of OCD.29 The first study investigating the possible anti-anxiety effects of 5-HTP is proved to be helpful.

St. John’s wort – Daily supplement. St. John’s wort contains the active ingredient hypericin, which reduces anxiety and depression symptoms.

Fish oil supplements – Rich in omega-3 fatty acids, have been shown to be effective in a wide range of psychological conditions. Fish oil supplements contain eicosapentaenoic acid, or EPA, an essential fatty acid important for your nervous system to improve thoughts associated with OCD and regulate the brain chemical serotonin.

Stress and Relaxation Techniques – Relaxation techniques may produce modest, short-term reduction of anxiety in people with ongoing health problems such as heart disease or inflammatory bowel disease, and in those who are having breast biopsies, dental treatment, or other medical procedures. These techniques have also been shown to be useful for older adults with anxiety. In people with generalized anxiety disorder, studies indicate that cognitive-behavioral therapy is more effective over the long term than relaxation techniques. For symptoms of depression they may have modest benefit, but they are not as effective as cognitive-behavioral therapy (CBT) or other psychological treatment. Find out more.

Meditation – Moderate evidence suggests that meditation is useful for symptoms of anxiety and depression in adults. Learn more.

Yoga – Yoga, which combines physical postures, breathing exercises, meditation, and a distinct philosophy, is one of the top ten CAM practices. Studies suggest that practicing yoga (as well as other forms of regular exercise) might confer health benefits such as reducing heart rate and blood pressure, and it may also help alleviate anxiety and depression.

Acupuncture – Evidence for the use of acupuncture – the Chinese practice of inserting needles into the body at specific points to manipulates the body’s flow of energy – to treat anxiety disorders is becoming stronger.

Kava – A plant found in the South Pacific, kava has been shown to be safe and effective in treating anxiety and improving mood.

 

Reference –

http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml#part_145346

http://ocd.stanford.edu/about/symptoms.html

http://psychcentral.com/lib/treatments-for-obsessive-compulsive-disorder/

http://psychcentral.com/lib/treatments-for-obsessive-compulsive-disorder/

http://www.health.com/health/gallery/0,,20707257,00.html

http://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm

http://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm

February 7, 2017

A mood disorder is a mental health class that health professionals use to broadly describe all types of depression and bipolar disorders. The Moods referred here are not the usual “ups-and-downs” or occasional “blues” that we all experience as part of life. They are forms of a “chemical imbalance” that result for various biological and/or environmental reasons.

Illness under mood disorders include: major depressive disorder, bipolar disorder (mania – euphoric, hyperactive, over inflated ego, unrealistic optimism), persistent depressive disorder (long lasting low grade depression), cyclothymia (a mild form of bipolar disorder), and SAD (seasonal affective disorder).

Mood – While many people use the term “mood” to simply refer to their feelings at any given moment (e.g. “I’m in a happy mood”), mental health professionals use it a bit differently. In clinical settings, it is used to describe a persistent emotional state that affects how the person sees the world.

Mood disorders are characterized by a significant disturbance in a person’s persistent emotional state or mood. The two primary types of moods are depression and mania. Thus, most mood disorders fall under the broad categories of depressive disorders and bipolar disorders (formerly known as “manic depressive” disorders).

Most individuals with a bipolar mood disorder experience episodes of depression as well as manic (or hypomanic) episodes. The term “bipolar” refers to these fluctuations in mood from one “pole” to the other.

Types of Mood Disorders

These are the most common types of mood disorders:

  • Major depression – Having less interest in usual activities, feeling sad or hopeless, and other symptoms for at least 2weeks may indicate depression.
  • Dysthymia – This is a chronic, low-grade, depressed, or irritable mood that lasts for at least 2 years.
  • Bipolar disorder – This is a condition in which a person has periods of depression alternating with periods of mania or elevated mood.
  • Mood disorder related to another health condition – Many medical illnesses (including cancer, injuries, infections, and chronic illnesses) can trigger symptoms of depression.
  • Substance-induced mood disorder – Symptoms of depression that are due to the effects of medication, drug abuse, alcoholism, exposure to toxins, or other forms of treatment.

Causes

Symptoms of depression in children and adolescents can be related to a number of things. It can be triggered by a sad or painful event like a death in the family. It can develop in children who observe constant fighting between their parents. It can also result from the child experiencing parental neglect or abuse.

However, being prone to more serious kinds of mood problems can run in families. They happen because chemicals in the brain that help regulate mood are not working properly.

Sometimes, when children are under stress early in life, their bodies change in a way that can make them react badly to stress for the rest of their life. As a result, they develop problems with depression and/or anxiety that can be lifelong.

Risk Factors

Sometimes, life’s problems can trigger depression. Being fired from a job, getting divorced, losing a loved one, death in the family, and financial trouble, to name a few, all can be difficult and coping with the pressure may be troublesome. These life events and stress can bring on feelings of sadness or depression or make a mood disorder harder to manage.

The risk of depression in women is nearly twice as high as it is for men. Once a person in the family has this diagnosis, their brothers, sisters, or children have a higher chance of the same diagnosis. In addition, relatives of people with depression are also at increased risk for bipolar disorder .

Once a person in the family has a diagnosis of bipolar disorder, the chance for their brothers, sisters, or children to have the same diagnosis is increased. Relatives of people with bipolar are also at increased risk for depression.

Symptoms

Depending on age and the type of mood disorder, a person may have different symptoms of depression. The following are the most common symptoms of a mood disorder:

  • Ongoing sad, anxious, or “empty” mood
  • Feeling hopeless or helpless
  • Having low self-esteem
  • Feeling inadequate or worthless
  • Excessive guilt
  • Recurring thoughts of death or suicide, wishing to die, or attempting suicide (Note: People with this symptom should get treatment right away!)
  • Loss of interest in usual activities or activities that were once enjoyed, including sex
  • Relationship problems
  • Trouble sleeping or sleeping too much
  • Changes in appetite and/or weight
  • Decreased energy
  • Trouble concentrating
  • A decrease in the ability to make decisions
  • Frequent physical complaints (for example, headache, stomachache, or tiredness) that don’t get better with treatment
  • Running away or threats of running away from home
  • Very sensitive to failure or rejection
  • Irritability, hostility, or aggression

In mood disorders, these feelings are more intense than what a person may normally feel from time to time. It’s also of concern if these feelings continue over time, or interfere with one’s interest in family, friends, community, or work. Any person who expresses thoughts of suicide should get medical help right away.

The symptoms of mood disorders may look like other conditions or mental health problems. Always consult a health care provider for a diagnosis.

Treatment

Mood disorders can often be treated with success. Treatment may include –

Antidepressant and mood stabilizing medications – especially when combined with psychotherapy have shown to work very well in the treatment of depression

Psychotherapy – most often cognitive-behavioral and/or interpersonal therapy. This therapy is focused on changing the person’s distorted views of himself or herself and the environment around him or her. It also helps to improve interpersonal relationship skills, and identifying stressors in the environment and how to avoid them

Family therapy

Other therapies, such as electroconvulsive therapy and transcranial stimulation.

Alternative Treatment

S-adenosylmethionine (SAMe) is an amino acid that is a major donor of methyl groups needed for synthesis of serotonin, norepinephrine, and dopamine, and is widely prescribed in Europe and gaining popularity in the United States. Some studies have shown levels to be reduced in patients with major depressive disorder.

Omega-3 fatty acids have become increasingly popular and seem to play a role in stabilizing neuronal membranes and facilitating monoamine neurotransmission. The human body is unable to synthesize essential fatty acids and so they must be ingested. The most common source is fish oil and many studies have shown that these supplements may balance mood.

There are several other products that are used, this includes – 5-hydroxytryptophan, Rhodiola rosea , Crocus sativus , chromium picolinate, Lavandula angustifolia , Ginkgo biloba , and chamomile.

St. John’s Wort – This may be the most-studied herb is effective for treatment of mild forms of depression.

Mind-Body Relaxation – Whether it’s guided imagery, meditation, or yoga, anyone who suffers from clinical depression or anxiety disorders can benefit from some mind-body relaxation technique.

Exercise – Regular exercise can beat the blues. But research suggests it helps with all levels of depression, even the most severe. Exercise may also help keep depression from coming back.

Melatonin improves sleep quality in people with schizophrenia, major depression, and seasonal affective disorder. This supplement may be an alternative to drugs, especially for children and the elderly.

 

Reference –

http://www.webmd.com/mental-health/mood-disorders

http://www.mayoclinic.org/diseases-conditions/mood-disorders/basics/definition/con-20035907

http://www.mentalhealthamerica.net/conditions/mood-disorders

http://www.dbsalliance.org/site/PageServer?pagename=education_mood_disorders

https://www.nlm.nih.gov/medlineplus/mooddisorders.html

http://www.hopkinsmedicine.org/healthlibrary/conditions/mental_health_disorders/overview_of_mood_disorders_85,P00759/

http://behavenet.com/mood-disorder

https://www.problemgambling.ca/EN/ResourcesForProfessionals/Pages/MajorMoodDisorders.aspx

http://www.allaboutdepression.com/dia_08.html

http://www.mdabc.net/

February 7, 2017

Migraines are a type of recurring severe headache that can cause you to have time off work and need to rest in bed. They are often accompanied by feeling sick, vomiting or an increased sensitivity to light.

It’s estimated that about 36 million Americans suffer from migraine, but only 1 of every 3 people talk with a doctor about their headaches. Of those, only half get the right diagnosis.

Women are roughly three times more likely to get migraines than men. About four in every 20 women get migraines, while only about one in every 20 men do. You can get migraines for the first time at any age, but they commonly start during the teenage years.

In general, a migraine is a very bad headache that tends to come back. It may occur as often as several times a week or only once every few years. It can last anywhere from a few hours to 3 days. The pain usually begins in the morning, on one side of the head. (In fact, the word migraine is derived from a Greek word that means “half-head.”) Less frequently, the entire head is swallowed up by pain.

The amount of pain can vary. Some migraines can be fairly mild, while others seem almost unbearable. Obviously, the worse the pain, the more trouble you have carrying out daily activities, whether it’s going to work or simply getting out of bed. Of course, different people have different abilities to put up with pain. For some people, even a mild migraine can force them to lie down; others are able to work through a more severe migraine.

Two types of migraines

While there are many variations, there are two main types of migraines –

Migraine without aura (previously called common migraine) – Almost 80 percent of migraine sufferers have this type of migraine.

Migraine with aura (previously called classic migraine) – This type of migraine announces itself about a half-hour before the onset of head pain with an aura.

Aura is a term used to describe the visual or sensory symptoms that some people get when their migraine is starting. The following are less common types of migraine –

  • Retinal migraines are headaches associated with visual changes in one eye only.
  • Abdominal migraines are associated with stomach pains, and happen more often in children.
  • Menstrual migraines can happen in women two days before their period starts or finishes.
  • Status migrainosus are migraines that can last for a few weeks.

Migraine is a medical condition that can have a big effect on your life and others caring for you. It can affect your daily life and can mean taking time off work or school.

Causes

There are many theories that discuss the causes of migraine. The cortical spreading depression (CSD) theory suggests that migraine is a disease of the brain such as angina is a disease of the heart. Disruption of normal brain functioning is believed to be the underlying cause of the migraine pain and aura. Another theory is the vascular theory which suggests that migraines result from the widening of blood vessels surrounding the brain. The chemical serotonin is also thought to play an important role in migraine development. While the precise cause of migraines remains unknown, a number of potential migraine triggers (habits or conditions associated with the onset of a migraine) have been identified.

Some people who suffer from migraines can clearly identify triggers or factors that cause the headaches, but many cannot. Potential migraine triggers include –

  • Allergies and allergic reactions
  • Bright lights, loud noises, flickering lights, smoky rooms, temperature changes, strong smells and certain odors or perfumes
  • Physical or emotional stress, tension, anxiety, depression, excitement
  • Physical triggers such as tiredness, jet lag, exercise
  • Changes in sleep patterns or irregular sleep
  • Smoking or exposure to smoke
  • Skipping meals or fasting causing low blood sugar
  • Dehydration
  • Alcohol
  • Hormonal triggers such as menstrual cycle fluctuations, birth control pills, menopause
  • Tension headaches
  • Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs and salami)
  • Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products and fermented or pickled foods
  • Medication such as sleeping tablets, the contraceptive pill, hormone replacement therapy.
  • A higher percentage of obese people have episodic (occasional) migraines compared to individuals with a healthy body weight.
  • Sudden weather changes, including a drop in barometric pressure or changes in temperature, humidity, or wind
  • Loud noises
  • Perfumes or fumes
  • Secondhand smoke
  • Exposure to glare or flickering lights

Symptoms

Migraine symptoms may begin one to two days before the headache itself. This is known as the migraine’s prodrome stage. Symptoms include –

  • Food cravings
  • Depression
  • Fatigue or low energy
  • Frequent yawning
  • Hyperactivity
  • Irritability
  • Neck stiffness

Some people may also experience an aura after the prodrome stage. An aura causes visual, motor, and/or speech disturbances, such as –

  • Difficulty speaking clearly
  • Feeling a prickling or tingling sensation in the arms and legs
  • Flashes of light
  • Seeing shapes, light flashes or bright spots
  • Transient vision loss

The next phase is known as the attack phase. This is the most acute or severe of the phases when the actual migraine occurs. Attack phase symptoms can last anywhere from four hours to three days. Symptoms of a migraine can vary from person to person. Some symptoms may include –

  • Feeling dizzy or faint
  • Increased sensitivity to light and sound
  • Nausea
  • Pain on one side of the head
  • Pulsing and/or throbbing pain
  • Vomiting

Risk Factors

Family history – You are much more likely to have migraines if one or both of your parents had migraines.

Sex – Women are more likely than men to have migraines.

Age – Most people have their first migraine during adolescence, but migraines can start at any age, usually before age 40.

Treatment

Medications

Analgesia – Over-the-counter medications such as naproxen, ibuprofen, acetaminophen (paracetamol), and other analgesics like Excedrin (aspirin with caffeine) are often the first abortive therapies to eliminate the headache or substantially reduce pain.

Anti-emetics – Metoclopramide may also be used to control symptoms such as nausea and vomiting.

Serotonin agonists – Sumatriptan may also be prescribed for severe migraines or for migraines that are not responding to the over-the-counter medications. Antidepressants such as tricyclics – are prescribed to reduce migraine symptoms although they are not approved in all countries for this purpose.

Ergots – Another class of abortive treatments is called ergots, which are usually effective if administered at the first sign of a migraine.

Alternative Treatment

5-hydroxytryptophan – Body makes the amino acid 5-HTP and converts it into serotonin, an important brain chemical. Researchers think abnormal serotonin function in blood vessels may be related to migraines, and some of the drugs used to treat migraines work by affecting serotonin.

Magnesium – People with migraines often have lower levels of magnesium than people who do not have migraines, and several studies suggest that magnesium may reduce the frequency of migraine attacks in people with low levels of magnesium.

Vitamin B2 – A few studies indicate that riboflavin may reduce the frequency and duration of migraines. In one study, people who took riboflavin had more than a 50% decrease in the number of attacks.

Coenzyme Q10 – CoQ10 can interact with several medications including blood thinners such as warfarin (Coumadin), some cancer medications, and medications for high blood pressure.

Melatonin – Melatonin can interact with a number of medications, so ask your doctor before taking it.

Butterbur – A few studies suggest that butterbur may help reduce both the frequency and duration of migraine attacks when taken on a regular basis for up to 4 months. More research is needed to see whether butterbur is really effective at preventing migraines.

Feverfew – Feverfew has been used traditionally to treat headaches, and several well-designed studies have found that it may help prevent and treat migraines.

Acupuncture has been studied as a treatment for migraine headache for more than 20 years. While not all studies have shown it helps, researchers agree that acupuncture appears safe, and may work for some people.

Chiropractic – In another study, people with migraine headaches were randomly assigned to receive spinal manipulation, a daily medication (Elavil), or a combination of both. Spinal manipulation worked as well as Elavil in reducing migraines and had fewer side effects. Combining the 2 therapies didn’t work any better.

Reflexology is a technique that places pressure on specific “reflex points” on the hands and feet that are believed to correspond to areas throughout the body. Some early studies suggest it may relieve pain and allow people with migraines to take less pain medication.

Reference –

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/headache-migraine

http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/treatment/con-20026358

http://www.medicinenet.com/migraine/article.htm

http://www.migraine.org.uk/get-involved/events

https://www.acponline.org/patients_families/pdfs/health/migraine.pdf

http://familydoctor.org/familydoctor/en/diseases-conditions/migraines.html

http://www.migraines.org/myth/mythreal.htm

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/headache-migraine