PARANOIA

What is paranoia?

He was always complaining or grumbling about something. Nobody could really comprehend his disorganized thought process.  His real name was unknown but we call him Kawasaki. He was the dumpster diver of the neighborhood. He was always disheveled consumed with a negative odor. This was my first experience of the mentally ill, then, growing up in the 70s in Surulere, Lagos. Today, as a mental health practitioner I now know he had a major symptom of paranoia as part of his diagnosis – if he had one. This is a thought process that causes one to have an irrational suspicion or mistrust of others. This word unfortunately has been misused, abused, a butt of jokes, and a source of slight. People with paranoia may feel like they’re being persecuted or that someone is out to get them. They may feel the threat of physical harm even if they aren’t in danger. People with dementia sometimes have paranoia, and it also can occur in people who abuse drugs. It can also be a symptom of a mental illness.

What is the cause?

The cause is unknown. This has confounded experts and different people will have different explanations for their own experiences. Paranoia could probably manifest itself through having confusing or unsettling experiences or feelings that cannot be explained away; been anxious or worried and the expectation of criticism or rejection from others; an uncritical thought process now allowing for flexibility; been isolated; and having experienced trauma. The use of drugs can cause paranoid behavior. It may be also a combination of factors, including genetics, stress and brain chemistry. The following are well known causes.

Little or no sleep: Having a single restless night is not an issue. But however going without sleep, for a week or more can start to take its toll. There was a time when people thought that sleep was simply a time when the body and brain “shut off” for a few hours each night to rest in preparation for the next day. But now scientists understand that neither the body nor the brain “shut down” when we sleep; in fact, they are often working even harder than they do during the day, breathing, undergoing processes to restore cells, process information, and improve health. It means not all the body “shuts down.” When one goes without sleep for long periods, you could even start to see and hear things that aren’t there (hallucinations). For adults the recommended span is 7 to 9 hours of sleep a night to stay alert and mentally healthy.

Stress: As a physical, mental, factor that causes bodily or mental tension, it can manifest via external or internal. If there is no outlet and pressure builds up one could start to feel more suspicious of other people. And it doesn’t have to be something negative like illness or job loss. Even a happy occasion, like a wedding, can create paranoid thoughts along with the joy. To help ease the tension; you can take time to relax and try to forget about what’s stressing you out; Spend time with friends; Find something to smile and laugh about; Get plenty of exercise; Meditate to clear your mind.

Psychiatric Disorders: A typical example Schizophrenia, can make it hard to tell what’s real and what’s imagined.  This disorder can cause negative thoughts about people that just aren’t true, like “They don’t like me,” “They’re making fun of me,” or even “They’re plotting against me.” In some cases, no amount of evidence will convince you otherwise. Most of the time, one simply cannot tell when thoughts have become paranoid. Friends, loved ones, or medical professionals often have to point it out and try to help you get treatment. Again, a word of caution, the fact that thought don’t make sense could be a sign of good mental health. But if these paranoid feelings happen all the time or start to disrupt home or work life, it might be time to talk to a mental health professional.

Drug Use: If paranoid thoughts are making you anxious or if you have minor symptoms of depression, drugs can make them much worse. In some people, they can trigger a psychiatric disorder with true clinical paranoia as a symptom.

Memory Loss: Alzheimer’s disease and other forms of dementia, which are more likely as one ages, can change the brain in ways that make you more suspicious of others. You might notice that a loved one with dementia starts to hide things like jewelry or money, or becomes convinced that people have bad intentions toward them. This is part of the disease.

Symptoms of paranoia

Everyone experiences paranoid thoughts at some point in their life, which for most people passes. The symptoms of paranoia are severe and can include:

•          Being defensive, hostile, and aggressive

•          Being easily offended

•          Believing you are always right and having trouble relaxing or letting your guard down

•          Not being able to compromise, forgive, or accept criticism

•          Not being able to trust or confide in other people

•          Reading hidden meanings into people’s normal behaviors.

How is paranoia diagnosed?

The doctor will perform a medical exam and take a complete medical history to help rule out a physical or medical reason for symptoms, such as dementia. If the paranoia is part of a psychiatric issue, there will be a referral to a psychiatrist or a psychologist. These professionals will then perform an evaluation with clinical psychological tests to help determine mental status. Other conditions that can occur in people with paranoia are: bipolar disorder; anxiety and depression

How is paranoia treated?

Treatment depends on the cause and severity of symptoms and may include medication and psychotherapy. Psychotherapy aims to help people with paranoia: accept their vulnerability; increase their self-esteem; develop trust in others; learn to express and handle their emotions in a positive manner

REFERENCES

https://www.healthline.com/health/paranoia

https://www.webmd.com/mental-health/why-paranoid#1

SELF ESTEEM

Introduction

This is a concept that has been abused and misconstrued. A prime example is the many media messages that are designed to make us feel lacking. The inherent greed of companies that want to sell their products usually start by making one feel bad about oneself, often by introducing a “problem” with the body that may never have been noticed otherwise. Barack Obama former President of the United States seized on the positive aspect of this concept by his well-known slogan of “YES WE CAN.” As an African American, he had an incredible level of self-esteem. People with this type of self-esteem accept and value themselves. He had the audacity to believe he could become the president of a nation that had historically denigrated the black person. He did.

My take

I can recollect my high school, been in the old “form three” and attending the Junior and Literary Dance. There were six of us, my peers, who use to always “hang out.” Between us during events like this, we use to boast as to who could ask the opposite gender to dance. Now, today, I see this as a self-esteem issue. Does one have the courage to get up from the comfort zone of your friends and walk across the hall to ask this beautiful girl to dance and if successful ask if she could be your girlfriend? Getting up in itself took courage and woe betides you, if you are turned down. Success however raised one’s duel with esteem and you are worshipped by your peers. Approaching the opposite gender had to do with confidence and to be comfortable with a possible rejection. This was the genesis of my self-esteem issues and today we still joke about this pivotal time in our lives.

But, what exactly is self-esteem?

Self-esteem in itself is used to describe a person's overall sense of self-worth or personal value. In other words, how much you appreciate and like yourself. Psychologists see it as a personality trait, which tends to be stable and enduring. American psychologist Abraham Maslow included self-esteem in his hierarchy of human needs. He described two different forms of "esteem"(a) the need for respect from others in the form of recognition, success, and admiration, and (b) the need for self-respect in the form of self-love, self-confidence, skill, or aptitude. Self-esteem is confidence in one's own worth, abilities or self-respect. This is made up of the thoughts, feelings, and opinions we have about ourselves. That means it is not fixed. It can however change, depending on the way we think. Over time, habits of negative thinking about ourselves can lower self-esteem. Possessing little self-regard is a road map to become depressed, to fall short of their potential, or to tolerate abusive situations and relationships. Too much self-love, on the other hand, results in an off-putting sense of entitlement and an inability to learn from failures. Sometimes, people don't even realize that they're thinking so negatively about themselves. But once aware of it, the way one thinks is up to the person and one can begin to change the thinking process. And changing the way one thinks about oneself changes the way one feels. Finally, it is okay to be different, good to be different, and that we should caution ourselves before we pass judgment on someone who looks different, behaves different, talks different, or is a different color.

Contributory Factors

The factors that contribute to low self-confidence combine and interact differently for each person.  Genes, cultural background, childhood experiences, and other life circumstances all play a role. Life experiences in itself is significant in that it creates individual perceptions which can lead to feelings of exhilaration or worthless. Following are examples…. Trauma: Physical, sexual, and emotional abuse can all significantly affect our feelings of self-worth. Parenting style: The way we were treated in our family of origin can affect us long after childhood. For instance, if you had a parent who constantly belittles one, compares one to others, or continually tells one NFA (No Future Ambition) or dullard, you likely carry those messages with you today. If this parent is an alcoholic, or/and a substance abuser can also change one’s relationship with the world. Bullying, harassment and humiliation: Childhood bullying can negate one’s your confidence especially when it comes to looks, intellectual and athletic abilities. Humiliating experiences in adulthood, including workplace harassment or a peer group that disrespects, can also make one less willing to speak up or pursue ambitious goals.

Common Characteristics of People with High Self-Esteem

To have confidence and believing in oneself.

Understanding who one is and the ability to problem solved.

The need to understand the need for effective communication skills.

Having an inner motivation to succeed.

To be comfortable with change.

Enjoy healthy relationships.

Be goal-oriented.

Ability to laugh at one self.

Are you a high functioning alcoholic?

The high functioning alcoholic

You may or not be aware of these people around you. Reading and digesting this article will not only make you aware but empower you as to what actions if necessary you need to take. They are family, friends, co-workers or even acquaintances.  These individuals, of either gender, struggle with problem drinking, heavy drinking, or constantly crave for alcohol. A functional alcoholic  is defined by people who have a dependence on, tolerance to, and intense cravings for alcohol, but who can they still maintain a job, complete school, and have apparently healthy relationships.  Despite the outward appearance of having everything together, they have problems with drinking. Because they succeed in society, high-functioning alcoholics are often very deeply in denial that they have a problem. It is not until their health begins to suffer, they experience major life issues (such as issues at work or damaged relationships), or they reach an emotional tipping point that they realize how bad their situation has become.

My Take

The death of my uncle from the twin evils of lung cancer and alcoholism … specifically, forced my view of the world and my sense of responsibility to take a dramatic turn. I now know he was a high functioning alcoholic for a long time. His occupation as a taxi driver for many years and his involvement in many projects belied a widespread belief he could cope. I had already accepted my uncle’s debilitation and had watched through the years as he experienced both prejudice and acceptance related to his addiction. His wife over the years had played the dual role of chastiser and supporter. During his numerous stays at various hospitals, she was known to smuggle alcohol and cigarettes to him. Despite been caught and banned, she would direct her children and other family members to do her bidding. At the time I never understood the concept of dysfunction and wondered aloud why she ‘hated’ him and wanted him dead. The truth is they loved one another and giving him what he wanted was her own way of showing she cared. She could not bear to see him miserable whatever the risk, even death. The whole family ‘bought’ into the notion of what I would call appeasement. The extended family, especially my father, was angry at this ‘suicide’ mission. There was a lot of disquiet with families pitted against one another. Unfortunately, the source of his addiction is unknown. His family was all guilty of some form codependence whether willingly or coerced. There was also compulsion on the part of the family to maintain their homeostasis regardless of the location. Emotional issues were raised in conflict from intervening families who disagreed with the sabotage of the treatment process.  This deep experience has enabled me to recognize the adversity that accompanies the good in life. But most importantly it made me the professional that I am today. With compassion comes an even greater responsibility. LUKE 12.48 tells us “TO WHOM MUCH IS GIVEN, OF HIM MUCH IS REQUIRED”. I have been opportune to be a social worker and have helped in the treatment of addiction. I feel blessed and I can see people from two vantage points; theirs and mine.

Signs of a functioning alcoholic

Consuming alcohol to cope: Alcohol should never be used as a means for coping with emotions or stressful situation. When an individual has their drinking habits under control, they may drink a couple of drinks once or twice a week with family or friends. In contrast, drinking can begin to get out of control when alcohol is used to reduce the stress of work, to feel happy after feeling depressed, or to reduce anxiety about a relationship. Drinking alone: This is perhaps one of the clearest signs of a high-functioning alcoholic. One of the major signs of a high-functioning alcoholic is when drinking is done alone, sometimes even in secret. Drinking too much too often: there is an objective measure for what consists of “heavy drinking” – that is, drinking too much on a daily or weekly basis. Building alcoholic tolerance: Consistently finishing off a bottle of wine after it is opened is not only a sign of high-functioning alcoholism but also builds up your tolerance for alcohol, creating a cycle of dependence. Functional alcoholics may seem to be able to keep control once they have been drinking, but it can be difficult to exercise the same control after going too long without a drink. For alcoholics, withdrawal can look like anything from feeling depressed or anxious, increasing irritability, or feeling nauseous or tired for an extended period of time.

Treatment

The good news, is, there is hope.  Alcoholism is a remediable disorder with the right kind of treatment. The treatment for a high-functioning alcoholic is making an appointment with the doctor about getting help. There will be a referral to a therapist, psychiatrist, or other addiction specialist. The most in-depth care allows you to live full time at a treatment facility. Also, a support group i.e. relating to other people with substance abuse issues needing assistance may help one break through denial and begin to recover.

Reference

https://americanaddictioncenters.org/alcoholism-treatment/the-functioning-addict

https://www.webmd.com/mental-health/addiction/high-functioning-alcoholic#1

MC COY PSYCHOLOGICAL HEALTH BENEFITS OF SLEEPING

What is sleep?

Sleep is a naturally recurring state of mind and body, characterized by an altered consciousness - a ‘down time’ in which we spend about a third of our lives. It is a process where a majority of the brain gets to relax.

Why sleep?

Difficulties sleeping and mental health problems are both public health concerns in their own right, with each having a substantive impact on both individuals and society as a whole. Sleep is as important to our health as eating, drinking and breathing. It allows our bodies to repair themselves and our brains to consolidate our memories and process information. Poor sleep is linked to physical problems such as a weakened immune system and mental health problems such as anxiety and depression. Therefore it begs the question, what really is the relationship between sleep and mental health and if so are the interventions designed to improve sleep also improve mental health? This relationship may well documented, with numerous reviews testifying to a robust link between the two, but it is equally impossible to determine if the effects are bidirectional in nature.

Sleep and mental health

We develop resilience and learn to cope when life constantly throws up challenges and difficulties. Sleep is especially challenging in shift based work, and in safety-critical industries like the railway, so it’s even more important to make sure we get the right amount of good quality sleep. In essence having enough sleep cannot be understated in enabling our resilience. It is in many respects a built in biological ability to bounce back.  As mentioned earlier, although the relationship between sleep and mental health is not clearly understood, it is believed that a good night's sleep helps foster both mental and emotional resilience. Sleep gives the brain some ‘down time’ to process all of this information and store it in our memory banks. This way, it is available and accessible when it is needed. Chronic sleep disruptions set the stage for negative thinking, depression, anxiety and emotional vulnerability.

Improving Sleep behavior

Health: It is well known that poor health affects sleep and vice versa. Mental health problems like Depression and anxiety, both debilitating disorders often are enablers of sleep problems. It’s important to get any health concerns addressing both mental and physical symptoms as soon as possible. Procrastinating may be dire for one’s long term prognosis.

Environment: Temperature, noise levels and light all play a part in determining one’s sleep. If you find yourself experiencing poor sleep, try keeping a sleep diary to see if there are patterns which can help identify a problem. Also where one sleeps is important, and the bedroom and bed should be mainly a place associated with sleep. In particular watching TV, playing with phones or screens, or eating in bed can all affect the quality of sleep. 

Attitude: It’s easy to get to sleep when one is able to relax, and let go of concerns. Due to life’s stressors it is common to have a night lying awake with worry. Just before sleep one could try to wind down, be less stimulated, and relax. Admittedly, it is be harder these days … raising children, traffic, political instability, unemployment, but relaxation techniques, such as a warm bath, music or mindfulness practice can all help. If sleeping is a problem, it is always best to get up, perhaps make a warm pap, and then try again when you feel sleepier. It can be tempting to turn on the TV or phone screen but this may stimulate you thus making it harder.

Lifestyle: What you eat and drink can affect your sleep. Stimulants like caffeine can make it harder to sleep, and a heavy or sugary meal close to bedtime can make sleep uncomfortable. Alcohol might seem to help you get to sleep, but it reduces the quality of sleep later. Taking exercise during the day is also a good way to aid sleep, but exercise releases adrenaline so exercising during the evening may be less helpful.

A Warning: Often the above basic techniques can improve one’s sleep. But, if you believe the inability to sleep,

·      has disrupted life’s functioning maybe at home, work or even driving

·      been elevated to a clinical disorder like Insomnia

the assistance of a sleep psychologist should be sought. Be prepared that the sleep problems can indicate other health issues. Treatment of the sleep and probable mental health problems can help address both symptoms and causes, leading to quicker recovery.

References

http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/depression-lack-of-sleep

http://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2009/July/Sleep-and-mental-health

SegoviaF, More JL, Lineville S, Hayle, RE and Haine RE: Mil Med 2013 Feb: 178(2): 196-201