Tuesday, 18 March 2014

Post-traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a condition which develops after you have been involved in, or witnessed, a serious trauma such as a life-threatening assault. During the trauma you feel intense fear, helplessness or horror. In some people PTSD develops soon after the trauma. However, in some cases the symptoms first develop several months, or even years, after the trauma.


  • Recurring thoughts, memories, images, dreams, or flashbacks of the trauma which are distressing.
  • You try to avoid thoughts, conversations, places, people, activities or anything which may trigger memories of the trauma, as these make you distressed or anxious.
  • Feeling emotionally numb and feeling detached from others. You may find it difficult to have loving feelings.
  • Your outlook for the future is often pessimistic. You may lose interest in activities which you used to enjoy and find it difficult to plan for the future.
  • Increased arousal which you did not have before the trauma. This may include:
    • Difficulty in getting off to sleep or staying asleep.
    • Being irritable which may include outbursts of anger.
    • Difficulty concentrating.
    • Increased vigilance.
    • Being more easily startled than you were before.


     Medication

    Antidepressant medicines are often prescribed. These are commonly used to treat depression but have been found to help reduce the main symptoms of PTSD even if you are not depressed. They work by interfering with brain chemicals (neurotransmitters) such as serotonin which may be involved in causing symptoms.
    Antidepressants take 2-4 weeks before their effect builds up and can take up to three months. A common problem is that some people stop the medicine after a week or so as they feel that it is doing no good. You need to give an antidepressant time to work. If one does help, it is usual to stay on the medication for 6-12 months, sometimes longer.

Depression

An estimated 1 out of 5 women and 1 out of 10 men will experience depression at some time in their lives, which makes this a very common ailment. Depression can prevent people from coping with their normal activities, their work, and their relationships, thus seriously compromising their sense of well-being and their ability to live their lives.

Psychiatrists generally consider someone to be suffering from depression when they present at least 5 of the following symptoms almost every day for at least 2 weeks:




  • Depressed mood for a large part of the day



  • Lack of interest or pleasure in almost all daily activities



  • Decrease or increase in weight or appetite



  • Insomnia or excessive sleeping



  • Agitated movements (such as wringing of hands) or slow movements



  • Fatigue or loss of energy



  • Feelings of worthlessness or excessive guilt



  • Indecisiveness or difficulty in thinking or concentrating



  • Recurrent thoughts of death (in 60% of cases) or suicide (in 15%)
  • Once a doctor diagnoses depression, it is important to begin a course of treatment as quickly as possible, to prevent the depressive state from getting worse. Left untreated, depression tends to become chronic or recurrent, and major depression leads to suicide in about 15% of the people who suffer from it.

    SYMPTOMS, TREATMENTS, AND CAUSES OF MANIC DEPRESSION 



    Manic depression has been known since ancient times, but it was a German psychiatrist, Emil Kraepelin, who first described its symptoms more systematically, in the late 1800s. Today, specialists prefer the expression “bipolar disorder”, which avoids the negative connotations associated with the word “manic”.

    Unlike ordinary people whose moods are influenced by specific events in their lives, people with bipolar disorder seem to follow their own cycle of mood fluctuations. Like passengers strapped into a roller coaster, they have no choice about the ups and downs; they must simply go along for the ride.

    And “ups and downs” is an appropriate description, because unlike depression (also known as “unipolar disorder”), bipolar disorder includes not only depressive states characterized by the same systems as depression, but also “manic” episodes that alternate with them.

    During these manic phases, individuals are excessively exuberant. Their thoughts race feverishly, leading to extravagant behavior. They see patterns everywhere—everything seems connected to everything else, and the smallest event can take on an exaggerated meaning. These people can also be very creative; the connections that they draw between things constantly inspire them with new ideas and new theories.
    More systematically, specialists often distinguish four major categories of symptoms of manic episodes:

    1) External appearance. The individual’s external appearance is extravagant or sloppy, provocative, or even indecent. A person in a manic phase may call out to strangers in the street with an abrupt familiarity, sometimes mixed with sarcasm.

    2) Mood exaltation. During manic phases, individuals feel exuberant and have extreme confidence in their own powers and charm. They have sexual adventures with no thought for the possible consequences and often with a total lack of inhibition or tact. They do not tolerate any criticism of themselves and are easily irritated and angered.

    3) Accelerated thought processes. Manic individuals’ thoughts come so fast that their words can’t keep up with them. They evoke one image, then move on to the next before their listeners have had time to absorb the first one. They keep jumping from one unrelated topic to another and keep talking even if people have stopped listening. Their ability to focus their attention is greatly diminished, but their imagination is greatly amplified.

    4) Motor hyperactivity. In manic phases, people don’t know the limits of their own strength. They don’t take the time to eat or sleep. They take on several projects at once without stopping to determine whether they are even feasible. These individuals make major upheavals in their lives (change jobs, go on long trips, make foolish expenditures, etc.) and may become distrustful or even paranoid, accusing the people around them of wanting want to keep them from carrying out their grandiose plans.

    From all these symptoms, one can easily see why it is vital to ensure that people with bipolar disorder receive appropriate treatment quickly. Even though the causes of these diseases are still incompletely understood, there are ways to reduce their effects considerably.



    So I thought this information could help us understand a bit more of how Hero was before she topped herself. Also Claudio could use some of these symptoms in the play, later on that is, when he starts to completely lose the plot.

    The Memory


    SHORT-TERM MEMORY



    In the course of a day, there are many times when you need to keep some piece of information in your head for just a few seconds. Maybe it is a number that you are “carrying over” to do a subtraction, or a persuasive argument that you are going to make as soon as the other person finishes talking. Either way, you are using your short-term memory.
    In fact, those are two very good examples of why you usually hold information in your short-term memory: to accomplish something that you have planned to do. Perhaps the most extreme example of short-term memory is a chess master who can explore several possible solutions mentally before choosing the one that will lead to checkmate.
    This ability to hold on to a piece of information temporarily in order to complete a task is specifically human. It causes certain regions of the brain to become very active, in particular the pre-frontal lobe.
    This region, at the very front of the brain, is highly developed in humans. It is the reason that we have such high, upright foreheads, compared with the receding foreheads of our cousins the apes. Hence it is no surprise that the part of the brain that seems most active during one of the most human of activities is located precisely in this prefrontal region that is well developed only in human beings.

    LONG-TERM MEMORY


    Information is transferred from short-term memory (also known as working memory) to long-term memory through the hippocampus, so named because its shape resembles the curved tail of a seahorse (hippokampos in Greek). The hippocampus is a very old part of the cortex, evolutionarily, and is located in the inner fold of the temporal lobe.
    All of the pieces of information decoded in the various sensory areas of the cortex converge in the hippocampus, which then sends them back where they came from. The hippocampus is a bit like a sorting centre where these new sensations are compared with previously recorded ones. The hippocampus also creates associations among an object’s various properties.
    When we remember new facts by repeating them or by employing various mnemonic devices, we are actually passing them through the hippocampus several times. The hippocampus keeps strengthening the associations among these new elements until, after a while, it no longer needs to do so. The cortex will have learned to associate these various properties itself to reconstruct what we call a memory.