Borderline personality disorder

Borderline personality disorder (BPD) is also known as emotionally unstable personality disorder (EUPD). It is a type of personality disorder and characterized by a pervasive and persistent pattern of instability and impulsivity.

Borderline personality disorder is an illness marked by an ongoing pattern of varying moods, self-image, and behavior. These symptoms often result in impulsive actions and problems in relationships with other people.

Prevalence in the general population is considered to be similar for both genders. In clinical samples, females represent three quarters of all patients. Some experts hypothesize this may be due to men’s difficulty accessing care, particularly psychotherapy.

It is estimated that between 1% and 4% of the general population and between 15% and 25% of mental health inpatients have a diagnosis of borderline personality disorder.

A person with borderline personality disorder may experience episodes of anger, depression, and anxiety that may last from a few hours to days.

People with borderline personality disorder may experience mood swings and may display uncertainty about how they see themselves and their role in the world. As a result, their interests and values can change quickly.

Researchers think that borderline personality disorder is caused by a combination of factors, including:
· Stressful or traumatic life events
· Genetic factors

Borderline personality disorder patients are exposed to risks due to their impulsivity – resulting in accidents, substance misuse and sexually transmitted diseases among others. Finally, instability in emotional and inter-personal relationships leads to communication problems between parents and children.

Some people with borderline personality disorder might be more likely to misuse drugs and alcohol as a way of trying to cope with the difficult emotions they experience.
Borderline personality disorder

Major depressive disorder

Depressive disorders often referred to as “clinical person” include major depression, dysthymia, and other related conditions that have plague humanity throughout history.

In this disorder individuals experience episodes of sad mood or anhedonia (loss of interest or pleasure) that last longer than two weeks.

It is often accompanied by low self-esteem, loss of interest in normally enjoyable activities, low energy, and pain without a clear cause. It is a multidimensional mental disorder that affects approximately one in seven individuals at some time in their life.

Major depressive disorder is estimated to affect more than 300 million people worldwide and is projected to become a leading cause of disability in developed countries.
Major depressive disorder

Bipolar spectrum disorder

Bipolar spectrum disorders affect many adolescents and their families, causing impairment in functioning at home, school and with peers.

The bipolar spectrum consists of features of bipolarity bedsides the classic kind found in DSM-IV in the criteria of bipolar disorder type I. Bipolar I disorder is defined by the presence of at least one lifetime manic or mixed episodes.

Bipolar spectrum disorder, occurs in person with severe major depression but not spontaneous hypomania or mania and yet with many signs of bipolarity.

Modern concepts of bipolar disorder are still developing and can include bipolar I and II, hypomania, cyclothymia, mania with depression and depression with hypomania, as well as highly recurrently major depression.

There may be long periods of normalcy between such mood swings, A smaller number of individuals in such families may show ‘schizoaffective’ disorders, characterized by both ongoing mood pathology and thought disorder. Hence a bipolar liability may manifest in a variety of ways.
Bipolar spectrum disorder 

Major depressive episode

A major depressive episode is a period characterized by the symptoms of major depressive disorder.

It is primarily severely depressed mood and a loss of interest or pleasure in most of the day, nearly every.

It is accompanied by other symptoms such as feelings of emptiness, hopelessness, anxiety, worthlessness, guilt and/or irritability, changes in appetite and weight loss, problems concentrating, diminished ability to think or concentrate, insomnia and recurrent thoughts of death or attempts at suicide.

In other words, the criteria for Major Depressive Disorder simply require that the patient experience at least one Major Depressive Episode and that the episode is not part of some oater psychotic disorder and is not part of other kind of mood disorder containing manic elements.

Note that for Major Depressive Disorder to be considered recurrent, on needs only to determine that there was a period lasting at least 2 months on which the depressive symptomatology consistently fell below the five-symptom threshold for q Major Depressive Episode – not a 2-month period of full remission.
Major depressive episode

What is dysthymia?

Dysthymia is a low grade chronic depression, formerly viewed as a character trait that was difficult to treat, but is now known to be responsive to antidepressant pharmacotherapy. It is being depressed most days, for most of the day, for at least two years and not without symptoms for more than two months at a time.

The DSM-IV defined dysthymia in adult requires at least two of the following:
*Poor appetite or overeating
*Insomnia or hyper-insomnia
*Low energy or fatique
*Low self esteem
*Poor concentration
*Feelings of hopelessness

The symptoms are required to cause clinically significant distress or impairment in social, occupational or other important areas of functioning and not to be cause by the direct physiological effects of a substance.

Dysthymia is more common in women less than 65 years of age, unmarried person, and young persons with low income.

In children and adolescent, dysthymia may be characterized by irritability (instead of sadness) and has to persist only for at least one year.
What is dysthymia?

Dysthymic disorder

Dysthymic disorder is distinguished from major depressive disorder by the fact that patients complain that they have always been depressed.

It is a chronic unipolar depressive disorder with depressive symptom present most of the day, more days than not, for 2 years. Dysthymic disorder is different from major depression in that the symptoms are not as severe.

Until 1980 most chronically depressed patients were considered to have a character disorder: depressive neurosis.

Dysthymic disorder is common among the general population and affects 5 to 6 percent of all persons.

The disorder is more common in women younger than 64 years of age than in men of any age and is more common among unmarried and young persons and in those with low incomes.

More than 75% of adults with dysthymia had other psychiatric disorders, particularly major depression, anxiety disorders and substance abuse.

Symptoms of dysthymic disorder among children and adolescents include irritability, pessimism, depression, low self-esteem, poor social skills, impairment of school performance and social interaction, changes in appetite, sleep problems, fatigue, problems with making decision, and feelings of hopelessness.

In dysthymic disorder, cognitive and social or motivational symptoms, not neuro-vegetative symptoms, were common.

Dysthymic disorder in the elderly does not appear to be a continuation of early adult dysthymic disorder. Instead, it is more often associated with health problems and loses, such as the loss of a role in retirement, the delta of family members or lost contact with old friends.

Younger patents were more likely to have symptoms of worthlessness, guilt, feeling trapped, feeling blue, feeling lonely, blaming the self, decreased sexual interest, and overeating.

Dysthymic disorder runs in families, along with major depression. Persons with dysthymia have increased rates of both dysthymia and major depression in their first degree relatives.

There also appears to be higher rate of some personality disorders in the families of person with dysthymia.
Dysthymic disorder

What is major depressive disorder?

It is a serious medical illness that disrupt a person; mood, behavior, thought process and physical health.

It is characterized by a persistent lowering of mood, loss of interest in usual activities and diminished ability to experience pleasure.

Major depressive disorder is a recurrent, episodic illness. This means that a person who has been depressed once and has recovered is likely to have one or more episodes of depression in future, often within 2 to 3 years.

Major depressive disorder has about a 50% chance of developing another episode at some later point. Once individual has two episodes, the odds of having a third increase to about 70%.

An episode of major depressive disorder may be classified as:
*mild
*moderate
*severe

Major depressive disorder may be accompanied by hallucination or delusions: these may be congruent or non congruent with the depressive mood.

Major depressive disorder can present with a variety of symptoms, however almost all patients display a marked change in mood, a deep feeling of sadness, and noticeable activities.
What is major depressive disorder?

Bipolar Depression

Bipolar Depression
Bipolar disorder is a serious disorder of the brain often confuse with depression alone.

Bipolar disorder was formerly called manic-depressive disorder. It is a type of depression, and it characterized by the presence of mood swings, especially "manic highs" that often result in high risk, self-damaging behavior.

Most individuals with bipolar disorder have both depressive episodes and hypomanic episodes.

The first to describe mania and melancholia as a bipolar disorder was the Greek physician Aretaeus of Cappadocia in the first century AD. He considered melancholia and mania as two manifestations of one and the same disease.

Almost 70 percent of all those with bipolar disorder are depressed at any one time. People who cycle spend three times as much time being depressed as being maniac.

When bipolar is insufficiently treated, people spend an average of four months of the year in depression.

In bipolar depression people are likely to sleep more, rather than less. Normally people with bipolar depression are more likely to have an earlier onset of symptoms and a greater number of depression episodes.
Bipolar Depression

The Symptoms of Depression

The Symptoms of Depression
The core signs and symptoms such as know mood, pessimism, self-criticism, and retardation or agitation seem to have been universally accepted. Other signs and symptoms that have been regarded as intrinsic to the depressive syndrome include autonomic symptoms, constipation, difficulty in concentration, slow thinking, and anxiety.

In 1953, expert listed 29 medical manifestations of autonomic disturbance, among which then most common in manic depression were hot flashes, tachycardia, dyspnea, weakness, head pains, coldness and numbness of the extremities, frontal headaches and dizziness.

There was reported a high frequency of medical symptoms, generally attributed to autonomic imbalance, among manic depressives.

Normally there were four different forms of complaints from patients:

• An unpleasant emotional state
• A changed attitude towards life
• Somatic symptoms of a specifically depressive nature
• Somatic symptoms not typical of depression
  

Although depression is generally considered an affective disorder, it should be emphasized that a subjective change in mood is not reported by all depressed patients. As in many other disorders, the absence of a significant clinical feature does not rule out the diagnosis of that disorder.
The Symptoms of Depression

Types of Depression

Anyone coming to study depression and trying to make sense of the differences can be easily overwhelmed by the different terms and descriptions given to depression.

The Diagnostic and Statistical Manual (DSM) the American system provide criteria for the diagnosis of:

Major depression
Major depressive disorder (single episode or recurrent)
Major depression melancholic type

Bipolar disorder
Mixed
Depressed
Seasonal pattern
Cyclothymia

Dysthymia
Depressive neurosis

Depressive disorder not otherwise specified
Types of Depression

Is adolescence really a Period of Storm and Stress?

Is adolescence really a Period of Storm and Stress? Are adolescents really more likely to experience psychological problems than either children or adults? The conclusion is that adolescents have a far worse reputation than they deserve. 

It is simply not true that most adolescents are emotionally disturbed or that most develop significant problems such as drug abuse and chronic delinquency. Instead, significant psychopathology characterizes only in a minority of adolescents, and many of them were maladjusted before they reached puberty and continue to be maladjusted during adulthood. 

In a comprehensive survey of mental health researchers discovered that about 10% of a sample of 14 year olds appeared to have serious psychological disorders and another 10% could be described as very miserable and negative about themselves. Rates of diagnosed psychological disorder were slightly higher in this population of 14 year olds than among a group of 10 year olds or among the parent of the youngsters studied. 

Yet adolescence is a period of heightened vulnerability to some forms of psychological disorder. After all, adolescents must cope with physical maturation, the emergence of new cognitive abilities, dating, changes in family dynamics, moves to new and more complex school setting societal demands to become more responsible and to assume adult roles, and more . 

Most adolescents seem to cope with these challenges remarkable well and undergo impressive psychological growth, although it is not unusual for them to feel depressed, anxious, and irritable now and then. For a minority, the stresses of adolescent can precipitate serious psychological disorders. 

Is adolescence really a Period of Storm and Stress?

Mood Disorders

The Depression
Definition
The person felt sad, or melancholy, from time to time. But there is a point where the ache of sadness becomes chronic and insufferable, a mountain of pain to its victim. Mood disorders, predominantly Depression and Bi-polar syndromes, are said to strike one in seven of the population.

Mood Disorders in Children and Adolescents
The two principal classifications for mood disorders are bi-polar (also known as manic-depression) and depression alone. Bi-polarity is characterized by wild mood swings ranging from deep sadness and depression to euphoric and manic type behavior. Depression is defined as a deep overriding sadness and feelings of despair. These feelings are all pervasive and don't disappear in time.

Children and adults who suffer from mood disorders cannot cope well in society. When depressed, they experience a loss of interest and lack of enjoyment in life. For a person with bi-polar disorder, the manic swings can create a disruptive influence on all aspects of their life and the lives of everyone around them.

Bi-polar disorder is classified in two categories: Bi-polar I and Bi-Polar II. Bipolar I Disorder is considered the classic form of manic depression, with full Manic Episodes and Major Depressive Episodes. Bipolar II Disorder involves Major Depressive Episodes and Hypomanic (non-full-blown Mania) Episodes. Since a significant portion of those suffering with manic depression do not have full manic episodes, the classification was divided into Bipolar I and Bipolar II. However, Bipolar II is often a first step to Bipolar I.

Bi-polar disorder appears to run in families, and there is some evidence that a biological vulnerability towards bi-polarity could be inherited. However, not everyone with this genetic vulnerability has the illness. Major depression also seems to appear generationally, but it too can occur in persons with no family history of the disease. An important factor that the research has uncovered is that major depressive disorder is associated with a neuro-chemical imbalance in the brain.
The Depression