Friday, October 28, 2016

Dissociative Identity Disorder

Dissociative Identity Disorder (DID) is characterized by the presence of two or more personalities. National Alliance on Mental Illness' 2016 article goes in depth on what DID is, the symptoms, how to support someone with DID and how to treat this disorder. "Dissociative disorders are characterized by an involuntary escape from reality characterized by a disconnect between thoughts, identity, consciousness and memory." DID can affect any nationality, age and socioeconomic background. NAMI also states "It's estimated that 2% of people experience dissociative disorders, with women being more likely than men to be diagnosed." Symptoms usually develop after a traumatic experience to keep the memories at bay. For example, abuse or combat. Sometimes, stressful situations can affect the disorder negatively and cause problems with everyday functions. This could be the way they talk to someone or whether or not they shower everyday, like they used to. DID is a disorder that abruptly occurs.
The DSM-5 goes into detail about what criteria a person has to have in order for them to be diagnosed with dissociative identity disorder. First, "a person must have two or more distinct identities or personality states are present, each with its own relatively enduring pattern of perceiving, relating to and thinking about the environment and self." This states that a person must have distinct personality change. For example, someone could be a shy person for a couple days and then all of a sudden they could become a little kid, which has no idea what is going on most of the time. The second criteria is: "amnesia must occur, defined as gaps of in the recall of everyday events, important personal information and/or traumatic events." An example of this would be someone forgetting where they live after living there for twenty years. The amnesia they are talking about is when someone forgets something that someone should never forget. Another criteria for this disorder is: "the person must be distressed by the disorder or have trouble functioning in one or more major life areas because of this disorder." This is a common criteria that is found in all mental illness diagnoses. The final criteria that the person must have is; "the symptoms are not due to the direct psychological effects of a substance (such as blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (such as complex partial seizures)." It is more appropriate to diagnose alcohol consumption or a medical condition because those are easier to treat and let alone when someone is told they have a serious disorder they start the denial process.
There are three different treatment options for dissociative identity disorder. First, psychotherapy is a popular choice of treatment. According to Psych Central psychotherapy "approaches vary widely, but generally take an individual modality (as opposed to family, group, or couple therapy) and emphasize the integration of the various personality states, into one, cohesive whole personality." Another treatment option is medications. Medication is rarely given due to the fact it is hard to maintain taking them when having a disorder where one minute your are yourself and the next you are someone completely different. If medications are given because of a psychiatric condition, then it should be carefully monitored to make sure the person stays healthy and on the medications, at all times. The last treatment option is self-help which is where people with the same disorder come together to form self-help support groups through larger communities and online. There is always help out there, whether you want it or not. Someone in a community close to yours could be going through the same thing and the people affected might never know until they find help. Help is not a bad thing. Asking for help shows that you are strong and that you are ready to take back your life. If you know someone or you think you might have DID please find help. There are therapists all over the world that can properly diagnose the disorder, so you aren't left in the dark thinking you have something you don't.

Thursday, October 27, 2016

Apologizing

Dear Mr. and Mrs. Smith,
I am sorry for the loss of your son, Jimmy. The hospital team, along with me, all did our best to help your son. We did everything by the books and when we were supposed to stop we kept trying to save him. We know you guys are a loving family by the way you and your husband cared for each other in this time of remorse. We again are sorry for your loss and we are sad that you or anyone else in this world has to go through something like this.
Sincerely,
Caligirl10271998

Sunday, October 23, 2016

Eating Disorders

According to ANAD, at least 30 million people of all ages and genders suffer from an eating disorder. Every 62 minutes at least one person dies as a direct result from an eating disorder. Eating disorders have the highest mortality rate of any mental illness. Having an eating disorder is like riding a bull, you fall off and the bull still tries to attack you. Most people say recovering from an eating disorder is the hardest thing in their life.
National Eating Disorders Collaboration explains what an eating disorder is and talks about recovery. "Eating disorders defy classification solely as mental illnesses as they not only involve considerable psychological impairment and distress, but they are also associated with major wide-ranging and serious medical complications, which can affect every major organ in the body." With an eating disorder, a person will try extremely hard to disguise or deny their behavior, but they may have disturbed eating behaviors coupled with extreme concerns about weight, shape, eating and body image.
There are three main eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder (BED). Anorexia nervosa causes people to obsess about what they eat, when they eat, and how much they eat. The symptoms are trying to maintain a below normal weight by either starving or too much exercise. People may also experience brittle nails, bruising, depression, sensitivity to cold and a slow heart rate. There are more than 200,000 cases per year. Bulimia nervosa is binge eating followed by purging. Purging is self-induced vomiting, misuse of laxative, diuretics or enemas. People with bulimia usually binge eat and then take steps to avoid gaining weight. This includes either purging or fasting. The symptoms are bad breath, food aversion, hunger, fatigue, water-electrolyte imbalance, abnormality of taste, depression, poor self-esteem, and a sore throat. Finally, according to NEDA, "Binge eating disorder (BED) is an eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during binge; experiencing shame, distress or guilt afterwards; not regularly using unhealthy compensatory measures (e.g., purging) co-counter the binge eating." BED is very similar to bulimia but a little more extreme. BED's symptoms are lack of control once one begins to eat, depression, grief and disgust or self-hatred about eating disorders. The binge eating occurs once a week, on average, for three months. Binge eating disorder is the most common eating disorder in the United States; it is estimated to affect 1-5% of the general population. BED affects 3.5% of women, 2% of men, and 1.6% of adolescents.
There are many ways to treat an eating disorder. The National Institute of Mental Health wrote an article on eating disorders and explains them in detail. "Typical treatment goals include restoring adequate nutrition, bringing weight to a healthy level, reducing excessive exercise, and stopping binging and purging behaviors." There are different options of treatment, such as, individual, group, or family psychotherapy, medical care and monitoring, nutritional counseling and medications. In individual psychotherapy the focus is the one-to-one relationship with the therapist. The individual with the eating disorder is focusing on his or her emotions and behaviors. Then, group psychotherapy is to help the people in the groups understand the projection they have towards other members, while learning from the feedback from the other people in the group and the therapist. The last one in this category is family psychotherapy helps family members understand what the patient is going through and how they can support them through their journey of getting better. Medical care and monitoring is when the patient goes and lives at an eating disorder facility and nurses watch them to make sure they are eating what they need to be eating. This only occurs if they have been to the hospital several times or if they aren't getting better. Finally, medication can't cure the eating disorder but it can help stay on the path to recovery. Antidepressants are the most commonly used with cases of bulimia and purging.
Evidence has shown that if you get treatment as soon as you realize you have an eating disorder, it would be a higher chance to fully recover. There are YouTube videos of the survivors that overcame this obstacle in their life. It is possible if you get help when you start seeing the symptoms. If you know or have heard of someone that could possibly have an eating disorder, try and find help. You could possibly save their life.

Monday, October 17, 2016

Schizophrenia

Schizophrenia is a very serious and dangerous disorder. It is where people reality abnormally. There is about 20,000 people that have this disorder. Webmd wrote an article on the different types of schizophrenia. "The main disorder is schizophrenia. It includes all the previous sub-types: catatonic, disorganized, paranoid, residual, and undifferentiated." This means that there are different types of schizophrenia a person can be diagnosed with. Rethink mental illness explains the eight different types of schizophrenia. To begin, paranoid schizophrenia is a common form. The person affected may have prominent hallucinations or delusions. In some cases, they can have both. This may develop at a later age and the person's speech and emotions may be unaffected. Then, Hebephrenic schizophrenia is where thought and behavior are unorganized. People may have a hard time understanding what the person is saying. With this form, pranks, giggling, health complaints, grimacing and mannerisms are common. Hebephrenic schizophrenia usually develops between the ages 15-25. Next, there is catatonic schizophrenia which is rarer than some types but, the person may not talk at all and have unusual movements. After that, there is undifferentiated schizophrenia. This is where the illness meets the criteria for the disorder but it doesn't fully fall into one of the eight categories. Also, with residual schizophrenia the person may be diagnosed if they have a history of psychosis. Simple schizophrenia is where negative symptoms are prominent and there are rarely any positive symptoms. The final type of schizophrenia is cenesthopathic schizophrenia. This is where the person has schizophrenia that isn't covered in any other categories. For example, people experience unusual bodily sensations. "Schizophrenia is characterized by abnormal social behavior. In severe cases, patients may see or hear things that aren't real."
Schizophrenia affects more men than women and it usually occurs in a person's late teens throughout their twenties. There are different types of treatments for schizophrenia. First, there are medications someone with this disorder can take. The only problem most doctors have faced is making sure the person keeps taking their medicine. Psychcentral.com wrote an article on the treatment that is available for those affected with this disorder. "Successful treatment of schizophrenia, therefore, depends upon a lifelong regimen of both drug and psycho-social or support therapies. While the medication helps control the symptoms and psychosis associated with schizophrenia (e.g., the delusions and hallucinations), it cannot help the person find a job, learn to be effective in social relationships, increase the individual's coping skills, and help them learn to communicate and work well with others." There are different types of therapies that can help someone that is affected by this disorder. Individual psychotherapy is when a therapist or psychiatrist the affected how to deal with their thoughts and behaviors. They will also learn more about the disorder and how it affects them personally. Cognitive behavior therapy (CBT) shows the person how to deal with "voices" and hallucinations. With combining CBT and medications they can see what triggers their psychotic episodes and how to reduce them. Finally, cognitive enhancement therapy (CET) teaches people how to recognize social cues and improve their attention. It combines computer-based brain training and group sessions. Psycho-social therapy comes in if the patient is improving with their psychotherapy sessions. Social skills training focuses on improving communication and social interactions. Then, rehabilitation occurs when the patient is trying to get a job. This includes job counseling, problem-solving support, and education with managing money. There is also family education and self support groups. Family education helps the loved ones become aware of what the person is going through and help them be as supporting as they can. Self support groups are outreach programs, such as the National Alliance on Mental Health, that help adults learn about their condition from other people who have experienced it themselves or watched someone experience it. 
Studies have shown that people affected with schizophrenia are more likely to do better with a good support group behind them. Loved ones and family members can also go through counseling to learn how to care for and or just support the person with the disorder. Sometimes, when people have a hard obstacle in their life, it is easier to overcome it with someone holding your hand the whole way. 

Sunday, October 9, 2016

Alzheimer's Disease

Alzheimer's disease is a chronic disease where brain cell connections and the cells die. In the beginning of the disease, patients encounter increasing forgetfulness or mild confusion. Alzheimer's Association posted an article that goes over the basics for the disease. "Alzheimer's is a progressive disease, where dementia symptoms gradually worsen over a number of years. It's early stages, memory loss is mild, but with late Alzheimer's, individuals lose the ability to to carry on a conversation and respond to their environment." Alzheimer's is not treatable but an individual can take medication to control their symptoms.
The National Institute of Aging wrote an article talking about Alzheimer's. There are three stages of Alzheimer's disease: mild Alzheimer's disease, moderate Alzheimer's disease, and severe Alzheimer's disease. The mild stage is where "As Alzheimer's disease progresses, people experience greater memory loss and other cognitive difficulties. Problems can include wandering and getting lost, trouble handling money and paying bills, repeating questions, taking longer to complete normal daily tasks, and personality and behavior changes. People are often diagnosed in this stage." My great grandfather had Alzheimer's disease. I would hear stories about him wandering out of the house at random hours of the night and he would get lost. My great grandmother would have to go search through the city to find him. As the disease progresses it becomes the moderate Alzheimer's disease where "damage occurs in the brain that control language, reasoning, sensory processing, and conscious thought. Memory loss and confusion grows worse, and people begin to have problems recognizing family and friends. They may be unable to learn new things, carry out multi-step tasks such as getting dressed, or cope with new situations. In addition, people at this stage may have hallucinations, delusions, and paranoia and may behave impulsively." My grandmother also has Alzheimer's and my sister and I went to visit her one summer. When we walked in to the house she had no idea who we were and she kept asking our names. My mother called her the day after and my grandmother did not remember us coming to her house. The final stage is severe Alzheimer's disease. In this stage " plaques and tangles spread throughout the brain, and brain issue shrinks significantly. People with severe Alzheimer's cannot communicate an are completely dependent on others for their care. Near the end, the person may be in bed most of or all of the time as the body shuts down."Tangles are twisted fibers of another protein called tau that builds up in cells and plaques are pieces of a protein fragment called beta-amyloid that build up in the spaces between the nerve cells. My aunt couldn't leave her bed when she was near the end. She had hospice care come and take care of her for her final couple months.
There are two different medications that individuals with Alzheimer's can take to modify their symptoms. There is cholinesterase inhibitors and memantine. Cholinesterase inhibitors boost levels of cell-to-cell communication by providing acetylcholine. Also, Memantine slows the progression of moderate to severe Alzheimer's disease. Although there isn't a cure for this disease these medications help control a person's symptoms enough for them to do everyday tasks again.
Not everyone is affected by Alzheimer's disease. The ages that are affected the most by this disease are sixty years old and up. Sometimes it is sooner, but that is rare.  There has been cases where dementia started at age nineteen. Everyone that has Alzheimer's disease that is in my family has started showing symptoms after being sixty years old. According to helpguide.org there are six pillars of Alzheimer's prevention. Pillar one is getting regular exercise. "According to the Alzheimer's research and prevention Foundation, regular exercise can reduce your risk of developing Alzheimer's disease by up to fifty percent. As we grow older be gin to isolate ourselves. To reduce Alzheimer's disease you should have a moderate amount of social engagement. This can be volunteering or just meeting up with a couple friends. When my grandmother lived at home the only other person she could talk to was her caregiver that lived across the street. Quality sleep and healthy eating also contribute to prevention. "Alzheimer's is sometimes described as "diabetes of the brain", and a growing body of research suggests a strong link between metabolic disorders and the signal processing systems." Not getting enough sleep can lower your immune system and so can eating unhealthy foods. The final two are stress management and mental stimulation. In the ground breaking NIH ACTIVE study, older adults who receive as few as ten sessions of mental training not only improved their cognitive functioning in daily activities in the months after training, but continues to show long-lasting improvements ten years later." This could be solving a puzzle or learning something new. It allows your brain to fire those nerves so they don't slow down and begin to die.
Alzheimer's is a very serious disease. There is a lot of research for it going on right now. 90% of the information researchers have they discovered it in the past fifteen years. Hopefully, in the next twenty years we will have a cure for Alzheimer's disease.

Sunday, October 2, 2016

Operating Room Nurses VS. Emergency Room Nurses

I knew from a young age that I wanted to help people, but I never knew how. My sister, who is eight years older than I am, went through nursing school a couple years after she graduated high school. As she was taking classes and getting her bachelor's degree in nursing I realized that nursing is the path for me. Now I am in school to become an emergency room nurse and my sister has had a job for a couple years now as an operating room nurse. Many people get these two career fields mixed up, but they are not the same. They just have similarities that all nursing professions have.
Operating room nurses can work in both large and small medical centers. Danielle Brown wrote on a blog called Gap Medics "Depending on the hospital, nurses may have a chance to specialize in a particular type of surgery." There are different types of surgeries people get when they go to a doctor such as pediatrics, heart, lungs, ortho, and general surgery. Operating room nurses work long hours, which are usually 12 hour long shifts 3 days a week. Gap Medics wrote a blog post on working in the OR as a nurse. There are three different types of OR nurses. A scrub nurse is a registered nurse that prepares the operating room. This includes laying out and organizing the surgical instruments. They also assess patients upon arrival and during the surgical procedure they pass instruments to the surgeon ad monitor the patient. A circulating nurse ensures all the patient's paperwork is done, such as consent forms. During the procedure, they may document what takes place and replenish surgical supplies as needed. After the procedure, they verify the instrument count and complete the charting for the patient. Registered nurse first assistants generally control bleeding, suture incisions and intervene when a complication occurs. Before the patient's surgery they give them pre-operative instructions or answer any questions and after the surgery they answer any questions and provide discharge instructions. The pros of being an OR nurse are working in the operating room can be challenging and exciting, and no shift is close to being similar. The cons are that you may deal with stressful situations and cope with the loss of patients and also hours are long which can be physically and emotionally draining.
Emergency room nurses usually work in emergency rooms in hospitals, urgent care centers, or helicopters. A day in an ER nurse is extremely fast-paced, which is either scary or exciting, depending on the person. Discover Nursing wrote an article on Emergency Room Nurses and how to become one. They wrote " with an emergency nursing background, you'll also have the option to work as an administrator, manager, researcher, or educator." This means that even if you went into this field there are more options to transfer to than just being a nurse and working with patients everyday. Kmoonshine wrote a comment on allnurses.com giving her pros and cons of being an ER nurse. Her pros are " there is never a dull moment, you're always being challenged to figure out what might be going on with a patient, and being able to develop great working relationships with the emergency department staff." Her cons are " dealing with impatient people, feeling overwhelmed when you are caring for multiple patients who are critically ill, and seeing some sad things people do to themselves and others, such as domestic violence, sexual assault, drug abuse, and suicide." With these pros and cons almost all nurses have to deal with most of the bad parts of a job.
Nurses are here to help people when they are sick or injured and in some cases not everyone leaves the hospital or facility they are being cared for. Every nurse has to deal with the loss and or the saving of a patient. The question is: Who would you want to save everyday for the rest of your life? I would rather save anyone and everyone I could. I don't see a difference between a hurt child and a mentally ill homeless person. They both need help and that is the reason me and thousands of others are going to school to get degrees.