Health and medical news blog

It’s important to recognize BDD in children and adolescents. As shown in Table 10, BDD can cause severe problems for children and adolescents. And in the inpatient study I’ve mentioned, adolescents with BDD had significantly greater anxiety, depression, and suicidal thinking than hospitalized adolescents without • BDD.Although the long-term consequences of BDD haven’t been well studied, it seems likely that when BDD develops during childhood or adolescence—rather than later in life—it may be particularly problematic. I’ve found that people who develop BDD before age 18 differ in some ways from those who develop it later. Indeed, we might expect that those with an earlier onset would be more impaired as a result of their symptoms because they’ve suffered for a longer time and during a developmentally critical period. Indeed, those with onset in childhood or adolescence are more likely to have been psychiatrically hospitalized (for any reason or because of BDD) and more likely to have attempted suicide.*156\204\8*

Neuro-transmitter substances
When a brain cell or neuron is activated it fires off electrically; this firing-off releases a small amount of a chemical at the end of the nerve fibre. This chemical is called a neuro-transmitter substance.
The neuro-transmitter substance in turn stimulates the next neuron to fire off. Thus the conduction of impulses in the brain is via an electrical-chemical – electrical – chemical -electrical, etc., process.
The neurotransmitter substances of the reticular activating system are different from those secreted by the learning/ unlearning cells of the cerebral cortex. Noradrenalin and serotonin are neurotransmitters which probably play an important role in this system.
Because changes in the level of neuro-transmitter substances available to be secreted at nerve endings can affect brain function, it is probable that the inhibitory reserve reflects levels of available neuro-transmitter substances. Should levels of these neuro-transmitter substances in the brain become diminished as in malnutrition or where the brain’s metabolism is disturbed’ then it is possible that the inhibitory reserve will be adversely affected.

Importance of sleep
However, the single most important factor in the regeneration of the inhibitory reserve is sleep. Sleep is an essential part of the treatment of all patterns of disturbed mental function, and the relationship between lack of sleep and irritability is so self-evident that there is no need for scientific proof. Every mother with experience of looking after cranky children who have missed out on their daytime nap, has learned for herself the relationship between sleep and the regeneration of the inhibitory reserve.

*19/129/5*

If we ask the nervous system to process conflicting information or to make a decision when it has already been programmed not to, it responds exactly as a computer would in similar circumstances. It responds with an error signal or alarm reaction. Thus an anxiety reaction may occur if we ask the nervous system to deal with inappropriate information.
For example, due to experiences in childhood a boy may have made a decision such as – ‘I will never ask anyone to marry me because I could never face the guilt if I couldn’t live up to the responsibilities of married life and have to leave like my father did!’ Because this vow or promise was made so long ago, and it was in association with painful memories, it was repressed into the unconscious mind, where it was out of reach of conscious recall, and therefore apparently forgotten. Now, many years later, this young man is preparing to ask his girlfriend to marry him, but he finds when he goes to pop the question, he develops anxiety symptoms. However, he is quite unaware of the reasons for this at the time and may even make the incorrect assumption that he doesn’t love the girl enough.
What the young man is doing is attempting to make a decision about marrying this girl while his nervous system is still programmed by the pre-existent decision which is unconscious, but still operative within the nervous system’s memory circuits. The decision-making process becomes blocked or ‘hung-up’, triggering an alarm or anxiety reaction.
In this case, anxiety arising in circumstances where the nervous system is neither apparently overloaded nor malfunctioning could be described as neurotic anxiety. The brain is overloaded in that it is failing to deal with a discrimination task which is too difficult for it to do. The person experiencing such anxiety would experience it in these circumstances whether he or she was otherwise over-stressed or not. However, it is obvious that a number of small, inner, deep conflicts such as the one I described might so use up the available computing space in the nervous system as to allow stress breakdown to occur at lesser levels of load than would happen in a person without such inner conflicts.
Inner conflicts thus lead to inefficiency and a lowered threshold for stress breakdown.
The most common conflicts interfering with our ability to tolerate high levels of stress without breaking down are conflicts over self-protection and self-discipline. Many people, when they experience anxiety symptoms, become anxious about being anxious. ‘How long will I be like this?’, ‘How do I know I’m going to get over this awful feeling of doom?’, ‘Howl do I know I won’t go insane like my great-aunt?’, ‘How can I be sure the doctor will be able to come if I call him?’, and so on. These conflicts can easily lead to a vicious cycle where the person’s focus of anxiety shifts to the question of being anxious. This type of vicious cycle, feeding on itself, is the basis; for phobic anxiety states, such as agoraphobia.

*9/129/5*

Panic anxiety management skills allow many of us to be free of our anxiety disorder. The skills can give us a control over our lives that we have never had before; but sometimes even this isn’t enough. A little-known aspect of the working-through process can hold us back, and be the final factor in the perpetuation of the disorder. It is our lack of sense of self.

Although this aspect is not related only to anxiety disorders, it can be the single most important issue in the disorders. Despite our ongoing attacks and anxiety, it can be the one issue we are most concerned about. It is as if we intuitively know the root cause of our suffering.

The lack of identification goes beyond our cry of ‘this is not me’. When we say ‘this is not me’ we are referring to the image we had before the disorder. Despite the image we had of ourselves, we have always known that we never felt any sense of who we are. We never had a real sense of self. This essential element was always lacking in our lives, and it is from this that our feelings of inadequacy, lack of confidence and lack of self-esteem arose.

We counteracted these by our need to be perfect. Over the years we adapted and modified our behaviour to what we perceived were other people’s expectations of us. We became who we thought we should be, and in doing so suppressed much of who we could be. Our identity became dependent on other people’s perceptions of us. The more dependent we became, the more we had to suppress our real self, even if we didn’t realise we were doing it. The more we suppressed our self, the more inadequate we felt. The more inadequate we felt, the more we felt the need to be perfect.

*100\94\8*

Considering the buzz surrounding the new herbal anti-depressant, it is likely that many people will choose to try and switch from the conventional anti-depressant they are already taking to the herbal remedy. Let me repeat a few suggested guidelines if you should choose to do so. I would recommend first that you involve your doctor in the process (someone must be prescribing the antidepressant, after all); second, that you switch gradually, overlapping the two medications in the transition phase; third, that you monitor your progress carefully to ensure that you do not suffer a relapse; and finally, that you be open-minded about returning to your previous treatment sooner rather than later if the exchange does not appear to be working out. The following story of one of my former patients illustrates a successful transition from a conventional to an herbal anti-depressant.

*15\75\2*