Medicines In Mental Health

You walk into a moderately business office sit down a chair in a well-dressed lobby and wait for your name to be announced. Finally, it comes and you are assessed by an intake worker, finally sent to a therapist a week later, and then recommended to the staff psychiatrist. In this short time, you were diagnosed with Bipolar, Depression, which is an element of bipolar, and posttraumatic stress disorder.

You also have a history of Diabetes, High-Blood Pressure, and Allergies. Now the doctor is not aware of the inflammatory fiber nerve disease underlying the symptoms. You continue to visit the mental health experts complaining constantly of your symptoms, and they begin treating you like a Hypochondriasis. (Someone occupied with health issues and most times are exaggerated)…you begin feeling confused, disappointed with the therapist, and decide to go to see a physician that finds a fiber nerve disease, which proves that you complaints are valid.

However, you were already given prescriptions for psychotic and depressive symptoms. You begin taking the medications and suddenly your insurance policy stops payment on the drug Effexor XR. Suddenly, you explode feeling aggressive, wanting to kill, wanting to die, wanting to harm and there is no explanation since these feelings has never occurred to this magnitude before you took the antidepressants prescribed. Now the problem has increased and you are searching desperately for an answer, yet you find nothing. What went wrong you might ask?

Well, Effexor XR is given to patients with depression and bipolar symptoms. Since Effexor is said to target the brain chemicals increasing the Norepinephrine and Serotonin in the brain, it is claimed to eliminate symptoms of depression and bipolar. Now Effexor XR is notorious (once the medication is stopped abruptly) for increasing behaviors including, suicidal thinking, impulsive behaviors, violent outburst and so forth.

The Prescription has caused increase in Blood making it a bad deal for patients with High-Blood Pressure. Now you went to the therapist to fix a problem and your problems has increased dramatically at it is all because of health care, mental health, medical, and so on. You start feeling that it cannot get any worse, but the doctors continue increasing your medicines prescribing Tenormin (Atenolol) for your pain and after prescribing numerous doses of inflammatory prescriptions, which lead to stomach disorders, you are now taking meds to control your stomach. Moreover, it does not stop here. Next, you are given Impramine HCL for pain, Tramadol for pain, and rotated between antidepressants finally prescribed Effexor XR again.

If you are feeling alone you are not, since many times doctors, mental experts, and health care providers make this mistake excessively many times to count. It is ludicrous to go to mental health experts all to find severe complications exploding your life and you are the one to blame, when in reality these experts made a serious mistake. Since the mental health expert obviously had no choice but to eliminate Hypochondriasis, and claim that they were only searching for answers to the problem (making excuses) you finally say I am searching for another mental health expert, since you have no idea what you are doing.

You go to the next office; sit, wait, and when you are called you talk to an intake worker, then a therapist, and finally a psychiatrist. You go through the same procedures wondering if these experts are smarter than the other experts you just left, and soon find yourself on Effexor XR, Impramine HCL, Tramadol, and a variety of other medications.

I told you people what happen before you tell the experts, yet they ignore your cries and tell you to take your medications as prescribed. Are we fixing problems or are we adding to the many problems we face every day. Some mental diagnoses were later proven a medical problem or central nervous interruption that created a series of symptoms delusional to mental health experts, believing that the patient was mentally ill.

Caught in a web of testing and despair we often fight to find a reason that our minds are tricking us into acting out of accordance to the so-called normal. The solution is right in front of them in most cases, yet everyone is turning their heads and looking for another answer.

ADD And College Students – How Does It Affect Them?

Unfortunately, Attention Deficit Disorder does not necessarily fade with age. Many people that suffer as a child will continue to suffer as a teen, as well as into adulthood. However, this disorder may affect people differently at different stages in their life.

College can be a difficult time for some students. For many, this represents a time of breaking free and starting their new uninhibited lives. This may be an exciting and emotional time. How does a college student with ADD face such a time?

For a person with Attention Deficit Disorder, this may prove to be a harsh time of transformation. Typically coming from families that were especially doting and accommodating to their situation, they are thrown in to a new environment to fend for themselves. One of the basic behavior modification techniques in training an ADD child is through structure, routine, and habit. At once, all of this is taken and it becomes the student’s responsibility to recreate this structured life they once had. Of course, a person with ADD is typically disorganized and unstructured. So, they may have a difficult time having the discipline to enact such stringent requirements for themselves.

Another aspect to consider is the increased difficulty in the academic load in college as compared to high school and the additional responsibility put on the students. Not only will the student be responsible for their own organization and structure, they will do so under more stress and academic pressure. This increasingly more difficult schoolwork is not made easier by the student’s general inattentive nature, distractibility, and impulsiveness. The very core of ADD makes college more difficult. With any luck, the student has spent enough time over the last few years regulating their own behavior that they will easily be able to in this new environment.

For the most part, the same steps should be taken in college to deal with ADD as was necessary in high school and other grades. To be effective, a student should carry some type of organizational calendaring system or digital organizer. In college, they do not hold the students’ hands like they do in high school – once an assignment is made, it is expected to be turned in on time, without reminders. Therefore, it becomes imperative to keep up with deadlines and dates. Students should also create structure and organization in their dorm or apartment and utilize the same skills they have been developing for years.

Anxiety Symptoms

Anxiety is a part of everyday life in the new millennium. But for people, it expresses itself much worse than for others. Anxiety symptoms that go beyond the typical expressions of unease and nervousness should not be ignored. While many people can expect to suffer an anxiety attack at some point in their life, recurring episodes of extreme anxiety are definitely not normal.

Anxiety itself is good. It serves as the body’s warning system that something may be amiss; that we need to move into a state of preparedness. Among these anxiety symptom are a rapid heartbeat, dry mouth and sudden perspiration. Surely nobody reading this has ever managed to escape those sensations.

But how many have been found themselves in stressful situations in which they became dizzy, grew short of breath, felt pain in their chest and a sudden need to urinate? While these are all common symptoms of everyday anxiety, if you find yourself feeling all of them, chances are you have gone beyond the norm and experiencing an actual anxiety attack. If you experience these symptoms on more than a few occasions, you may be to the point where you should consult a doctor.

Still, even these anxiety symptoms do not definitely mean you are experiencing an anxiety disorder. After all, the human body responds differently to varying situations of stress. For some people, the very thought of walking onto a stage and speaking to a large crowd of people would bring on all of the above symptoms without it necessarily indicating a disorder.

However, if in addition to the above, you also experience one or more of these anxiety symptoms, it is definitely past the point where you should at least be conducting some research. If you begin to experience deep feelings of apprehension, or even outright dread, of certain situations even when you are not anywhere near to being in those situations and you experience the physical symptoms, chances are you anxiety is to the point of a disorder. In addition, isolation of oneself from others can often be a sign of a more serious problem. Nervousness, jittery behavior, irritability, jumpiness; all of these are normal responses under certain circumstances, but if you notice a link between feeling them and either facing or just thinking about stress-inducing environments or events, it may be time to consider professional help.

Anxiety symptoms are a normal part of the day for most of us. Unless you get to work at your dream job and then go back to your dream home life, chances are you will experience a facing pulse, or a dry mouth today. It can be difficult to determine if the anxiety you are feeling is normal or something more. The worst thing to do is compare your reactions to anybody else; what may seem excessive to them might actually be normal for you. However, if you do find yourself experiencing these anxiety symptoms and you are concerned, definitely seek out the advice of friends and family to help locate the possible source of your anxiety.

Asperger’s Syndrome- Is There Real Cure For It?

If you know of a child who is having a greater degree of language impairment than other children or has diminished communication skills and also exhibits a restrictive pattern of thought and behavior, he may have Asperger’s syndrome. This condition is more or less similar to that of classic autism. The main difference between autism and Asperger’s syndrome is that the child suffering from Asperger’s syndrome retains his early language skills.

The peculiar symptom of Asperger’s syndrome is a child’s obsessive interest in a single object or topic to the exclusion of any other. The child suffering from Asperger’s syndrome wants to know all about this one topic.

Sometimes their speech patterns and vocabulary may resemble that of a little professor. Other Asperger’s symptoms include the inability to interact successfully with peers, clumsy and uncoordinated motor movements, repetitive routines or rituals, socially and emotionally inappropriate behavior, and last, but not least, problems with non-verbal communication.

Asperger’s syndrome sufferers find difficulty mingling with the general public. Even if they converse with others, they exhibit inappropriate and eccentric behavior. The Asperger’s syndrome patient may always want to talk about his singular interest.

Developmental delays in motor skills such as catching a ball, climbing outdoor play equipment or pedaling a bike may also appear in the child with Asperger’s syndrome. Children with Asperger’s syndrome often show a stilted or bouncy walk, which appears awkward.

The therapy for the Asperger’s syndrome mainly concentrates on three-core symptoms: physical clumsiness, obsessive or repetitive routines, and poor communication skills. It is unfortunate that there is no single treatment for the children suffering from the entire three-core symptoms. But professionals do agree that the syndrome can be cured when the intervention is carried out at the earliest possible time.

The treatment package of Asperger’s syndrome for children involves medication for co-existing conditions, cognitive behavioral therapy, and social skills training. The Asperger’s syndrome treatment mainly helps to build on the child’s interests, teaches the task as a series of simple steps and offers a predictable schedule.

Although children suffering from Asperger’s syndrome can mange themselves with their disabilities, the personal relationships and social situations are challenging for them. In order to maintain an independent life, the Asperger’s syndrome sufferers require moral support and encouragement to work successfully in mainstream jobs.

Studies are on the way to discover the best treatment for Asperger’s syndrome, which includes the use of functional magnetic resonance imaging (MRI) to identify the abnormalities in the brain which causes malfunction of the same, which in turn result in Asperger’s syndrome. Clinical trials are being conducted to identify the effectiveness of an anti-depressant in Asperger’s syndrome individuals. Even the analysis of the DNA of the Asperger’s syndrome sufferers and their families may cause a break through in the treatment of the Asperger’s syndrome.

Bulimia Nervosa – An Eating Disorder

Bulimia Nervosa commonly known as Bulimia is an eating disorder affecting men as well as women. It is a combination of binge eating followed by vomiting. When a person suffers from bulimia he or she eats large amount of food within a short period of time and vomit the same by using purgatives to avoid weight gain. It is a psychological problem due to issues with their weight, emotional baggage, depression, stress or self-esteem problems. It becomes very hard to find out if a person is suffering from bulimia. People who suffer from bulimia look normal as well as have normal weight, some may happen to be overweight. Many of the eating disorder problems are done behind closed door adding to its secrecy. Family and friends support is very important for patients who suffer from this problem. Initially patients may deny then resists the fact about such problem and end up being angry with others and themselves. The main cause can be due to their shape and size which is very often determined by the things they see around and want to imitate the same.

Some other problems you face due this act of binging and purging aretooth erosion due to acidic reflux, swelling and soreness of the salivary glands due to repeated vomiting, abdominal problems like ulcers, ruptures, build up of fluid in intestines, problems with bowel movement, dehydration and electrolyte imbalance. Some common symptoms to determine a bulimia patient is eating without control, purging, strict dieting and fasting, strenuous exercise routine, depression, increasing use of bathroom after meals, heartburn, moody behavior, weakness and exhaustion.

A person suffering from bulimia can get better by using different therapies. There are no specific home remedies but a constant need to change ones present lifestyle can make a difference. You can join group therapy, family therapy or individual therapy which makes a lot of difference in your life. Have supportive friends around you. Talk to your friends about the inner turmoil you go through everyday. Talk about matters which concern you and be comfortable in your skin. Remove the guilt pangs from your mind and look forward for a better and healthy living. You can also try hypnosis as it is known to have worked on people.

Warning: The reader of this article should exercise all precautionary measures while following instructions on the home remedies from this article. Avoid using any of these products if you are allergic to it. The responsibility lies with the reader and not with the site or the writer.

Depression And Anxiety Could Be Cured By Natural Supplements

Anxiety disorders are the most common mental health problem, and include panic disorders, agoraphobia, generalized anxiety disorder, social anxiety, and post-traumatic stress disorder. Anxiety disorders develop due to an interplay between enviromnental and genetic factors. Cognitive behavior therapy is useful for this disorder, as well as prescription anxiolytic drugs.

However, many patients prefer a natural approach or dislike the side effects of prescription drugs, and there are many non-prescription supplements available to help anxiety. Before starting natural supplements for an anxiety problem, be sure to mention your concerns and get a general checkup from your doctor. Symptoms resembling anxiety and anxiety attacks can be caused by physical diseases such as hormone imbalance, hyperthyroidism or cardiac arrhythmias.

However, if you are sure your problem is an anxiety disorder, the following supplements may be of help, and often have fewer side effects than commercial pharmaceutical products.

Chamomile tea is one of the best-known natural remedies for anxiety. Its affects the digestive tract and the nervous system, thus it is helpful for people who suffer from gastro-intestinal symptoms such as cramps along with mental anxiety. It is recommended that patients drink fresh tea made with chamomile leaves, 1/2 to 1 teaspoon per cup of water, several times a day. It is also available in tinctures which can be added to water. Chamomile capsules are convenient to take along to work, and don’t take as long to brew as the tea. The usual dose is 250 to 500 mg 3 to 4 times daily.

Damiana (Turnera diffusa) is a nerve tonic which also has a restorative (adaptogenic) property. It has a calming effect in cases of mild depression and anxiety, and is also reputed to be an aphrodisiac. Damiana contains flavonoids that act on benzodiazepine and GABA receptors. It exhibits anxiolytic activity, muscle relaxation and sedation. Use 2-4 g of dried leaves infused in a cup of boiling water; 2-3 cups are taken daily. Alternatively, 2-4 ml of a liquid extract or 3-4 grams of powdered leaf in tablets or capsules taken twice daily can be substituted if desired.

Damiana has demonstrated mild hypoglycemic effects in animal studies. Patients with diabetes and hypoglycemia should use this plant with caution, and monitor blood sugar levels closely. Damiana has a traditional use as an abortive and is contraindicated during pregnancy.

Kava Kava (Piper methysticum) has a very quick calming effect on the nervous system and causes an uplifting, euphoric feeling. It is also a muscle relaxant and mild sedative. It is helps anxiety, tension, stress, irritability and insomnia. Kava stops the mind from racing, often a symptom of generalized anxiety disorder.

The usual dose is 750 mg twice daily. Do not exceed 4 capsules per day.

Kava Kava is a traditional Polynesian remedy, and while it has been used safely by Polynesians for centuries, now that it has become popular worldwide it has been linked to some cases of liver failure in people of other ethnic groups who have difficulty metabolizing it. Ask a health care professional before use if you have a history of liver problems, frequently use alcoholic beverages, or are taking any medication. Stop and see a doctor if you develop symptoms that may signal liver problems (e.g., unexplained fatigue, abdominal pain, loss of appetite, fever, vomiting, dark urine, pale stools, yellow eyes or skin).

Do not use kava kava if less than 18 years of age, or if pregnant/breastfeeding. Do not combine with alcoholic beverages, or prescription anxiolytics or antidepressants . Excessive use, or use with products that cause drowsiness, may impair your ability to operate a vehicle or heavy equipment. Do not take Kava Kava on a daily basis for more than four weeks without consulting a health care provider. Take frequent breaks from use.

Passionflower (Passiflora incarnata) is most often used for insomnia, but it can also be taken in the daytime to reduce the effects of stress and anxiety. This herb is often included in European formulas for heart palpitations, which often have anxiety as a component. It is taken in capsule form, 500 mg daily, or 20-30 drops of tincture, or as a fresh tea. Passionflower, though it helps bring on natural sleep, does not have the sedative effects of many prescription sleeping pills.

Pulsatilla is a homeopathic remedy said to be most suitable for shy, hypersensitive people who tend to feel warm rather than cold. Homeopathic practitioners recommend a 30C potency 2-4 times daily for relief of acute symptoms, and 30C or 6C 1-2 times daily for chronic use. Homeopathic remedies use miniscule concentrations of compounds to “nudge” the body into healing itself. They either help or they do not; there are no toxic side effects.

Scullcup (Scutellaria lateriflora) is a relaxing and gentle sedative for the central nervous system. It is very good for nervous tension and for nervous exhaustion plus neurological and neuromotor problems. The dose is 10-20 drops of fresh plant tincture or 1-2 dropperfuls of dried plant tincture. Skullcap can also be sleep inducing, but it is rarely habituating.

St. John’s Wort (Hypericum perforatum) is commonly used for depression, but helps anxiety as well. Use a 300 mg extract 3 times daily. Quality varies widely between brands; it is best to buy a product standardized to contain 3-5% hyperforin and 0.3% hypericin. It works by increasing the level of neurotransmitters in the central nervous system such as serotonin and dopamine. Do not use this product if also taking prescription antidepressants.

Valerian (Valeriana officinalis) has been used since Greek and Roman times to promote sleep and relaxation. It can treat insomnia, anxiety, and stress related gastrointestinal upset. According to one theory, valerian affects the brain in a way similar to valium; while another theory holds that valerian contains GABA, a neurotransmitter which has a calming affect on the brain, or else influences the brain’s natural production of GABA. Also, some reasearchers believe that valerian affects serotonin levels in a manner similar to anitdepressant drugs such as Prozac.

If using valerian to treat insomnia, take the herb 30 to 60 minutes before going to bed. It can be taken 2-4 times daily to help stress and anxiety. The recommended dose of tincture is 30-60 drops, or a capsule or tablet of 300-500 mg.

Some people feel groggy after taking valerian; if this occurs, lower the dose. Avoid hazardous activities while using valerian, and do not combine it with other sedatives, antidepressants or alcohol. Do not take valerian for more than 3 weeks, as it can be habituating.

Verbena (Verbena officinalis) is a relaxing nervous system tonic indicated for a wide range of nervous disorders including nervous exhaustion and stress. As a tincture, use 2-4 mls up to 4 times daily. Avoid use during pregnancy as this herb is a uterine stimulant.

Withania (Withania somnifera) is an ayurvedic herb sold under the name Ashwaghanda. It is a very good tonic herb that is especially helpful for debility and nervous exhaustion due to stress. It has steriodal, adaptogenic, sedative and anti-inflammatory properties. It is also useful for panic attacks and phobic disorders such as agoraphobia. Use 1 tsp powder 3 times daily.

Do I Really Have Bulimia?

Bulimia is term used commonly for an eating disorder called Bulimia nervosa. It is a psychological condition in which a person engages in recurrent binge eating followed by intentionally doing one or more of the following in order to compensate for the intake of the food and prevent weight gain:

* vomiting

* inappropriate use of laxatives, enemas, diuretics or other medication

* excessive exercising

* fasting

The following six criteria should be met for a person to be diagnosed with bulimia.

1) The person feels incapable of controlling the urge to binge, even during the binge itself, and consumes a larger amount of food than a person would normally consume at one sitting.

2) The person purges him or herself of the recent intake, resorting to vomiting, laxatives, diuretics, exercising, etc.

3) The person engages in such behavior at least twice per week for three months.

4) The person is focused upon body image and desperate desire to appear thin.

5) The person does not meet the diagnostic criteria for anorexia nervosa. Some anorectics may demonstrate bulimic behaviors in their illness: binge-eating and purging themselves of food on a regular or infrequent basis at certain times during the course of their disease. Alternatively, some individuals might switch from having anorexia to having bulimia. The mortality rate for anorectics who practice bulimic behaviors is twice that of anorectics who do not.)

6) The person is of normal weight or overweight.

Bulimia is often less about food, and more to do with deep psychological issues and profound feelings of lack of control. Binge/purge episodes can be severe, sometimes involving rapid and out of control feeding that can stop when the sufferers are interrupted by another person or when their stomach hurts from over-extension. This cycle sometimes repeated several times a week or, in serious cases, several times a day. Sufferers often use the destructive eating pattern to gain control over their lives.

This article is presented for informational purposes only and should not be interpreted as medical advice. Please see the advice of qualified professional if you or someone you know suffers from bulimia.

Permission is granted to reprint this article as long as no changes are made, and the entire resource box is included.

Drug addiction

When looking at drug use, drug abuse, drug dependency and drug addiction, one finds that there are many divergent opinions about these terms and how they identify the drug-using behaviors of the public. Dr. Alan Leshner, the Director of the National Institute of Drug Abuse for the U.S. Government, states: “There is a unique disconnect between scientific facts and the public’s perception of drug addiction,”

From a lecture in March, 1998 at the National Institutes of Health, Dr. Leshner explained how brain function is modified by drug use and how that change persists after an individual stops taking drugs. Addiction also has to be recognized as a result of many bio-behavioral factors.

Dr. Leshner said a user does not have control over the change when voluntary drug use becomes a compulsive addiction. He likens the change to a flip of a switch, although the change may be a result of opponent processes where changes have accumulated over time. Regardless, Dr. Leshner believes it is important that people understand that once addicted, a person is literally in a different brain state.

Anyone that has known and witnessed the changes in behavior and ethics in a person caught in the thralls of addiction can see the declining spiral of personal care and ethics, work ethics, emotional stability and generally, a feeling that one hardly recognizes the addicted person as being the same individual as they were before the drug use.

One very important point to know is that any drug use may set off these destructive behaviors in an individual and that using drugs “recreationally” is playing Russian Roulette with one’s life. The effects of these “poisons” on the brain and nervous system are always destructive, but the timeline of when the effects will be obvious varies from immediately to, sometimes, after years of “casual” use.

The scientist’s say that one of the tasks of treatment is to revert the brain to its original state or repairing the damage that these poisons can do. Some scientist believe that this can be done by introducing other drugs, then called medicines, into the delicate brain chemistry of someone suffering from drug addiction. That is what National Institute of Drug Abuse (NIDA) is doing now as it begins to design new medications. “We have molecular targets,” Dr. Leshner said.” We don’t need serendipity.” Serendipity is defined as “a natural gift for making useful discoveries by accident.”

However, don’t be fooled by the scientist since they have yet to discover any medications that restore a person to full and, more importantly, enthusiastic living. These “medicines” are always a tradeoff in giving up some of the beauties of life to keep the addict from using a more destructive drug. For a total cure, one should pursue getting the original poisons out of the body and letting the body’s natural repair mechanism restore the person to his original, functional and loving self.

Eating Disorders And How To Treat Them

Many people are having problems with their weight. These weight problems are the results of a person’s eating habits. In the United States, there are about 50 million of Americans are enroll weight loss programs. However, there are also people who wishes that they would have a lesser weight and resulted to suffering from eating disorders.

Eating disorders may be categorized as a psychiatric problem. Although many experts say that obesity is not truly a psychiatric problem, they consider that the state of being obese is also a form of eating disorders. Some people who are trying to lose weight may lead to the improper obsession of thinking of a person that his dieting becomes abnormal.

Another form of eating disorder is the anorexia nervosa. This form of eating disorder may happen to those people who may have a normal or a little above the average weight. These people think that their body is always overweight. This illness may begin to those who that have continuous diet regimens and eventually led to restraining the person’s balanced eating.

Anorexia nervosa can be identified to most women that are teenagers and are in their early adult stages. Although it is not common to males and to older adults, it can also occur to these types of people. The known classic dieters do not eat any food in a day which lead them to starvation. The self-starvation of a person is the point where he suppresses hunger sensations, which may lead an individual to become skeletal in appearance. These individuals are considered anorexic by type because they suffer from phobia on gaining weight.

Bulimia can be truly associated to many dieters especially to those individuals aged 17 to 25 years old. The process of bingeing and purging of most bulimics can make an individual addicted on what he has started in his diet regimen. Most of the time a person can no longer control the binge and spurge cycle that and led a person to be underweight and or even obese. However, most bulimics appear to be normal and have a normal body weight. Most of the time, the process in which they do their dieting is kept to themselves because most bulimics are shameful of their activities of bingeing and purging.

There are side effects an individual may suffer from for being bulimic especially for women that are actively in this process of dieting. An irregular menstrual cycle may occur to some women and the decrease of sexual interest may be experienced. Most bulimics have disturbing behavior on whatever things they would like to do. There are instances where bulimics have tendencies to be drug addicts and alcoholic. Some of which have records of shoplifting and other cases that are associated in such acts.

There are some different approaches on how to treat these forms of disorders. These ways may help bring back the proper eating and correct way to have a balanced diet. A well-known stage for bulimics could return the right eating pattern by not practicing the activity of bingeing and purging. They are able to control the incorrect dieting behavior on the diet regimen.

A consultative approach that would be advisable to those bulimics and anorexic is the therapy program. Many of the patients have been found to cooperate well and let themselves to be educated in psycho educational programs that will give them the information on the illness.

Eating Disorders and Personality Disorders

Question:

Do narcissists also suffer from eating disorders such as bulimia nervosa or anorexia nervosa?

Answer:

Patients suffering from eating disorders either binge on food or refrain from eating and sometimes are both anorectic and bulimic. This is an impulsive behaviour as defined by the DSM and is sometimes comorbid with Cluster B personality disorder, particularly with the Borderline Personality Disorder.

Some patients develop eating disorders as the convergence and confluence of two pathological behaviours: self-mutilation and an impulsive (rather, obsessive-compulsive or ritualistic) behaviour.

The key to improving the mental state of patients who have been diagnosed with both a personality disorder and an eating disorder lies in focusing at first upon their eating and sleeping disorders.

By controlling his eating disorder, the patient reasserts control over his life. This newfound power is bound to reduce depression, or even eliminate it altogether as a constant feature of his mental life. It is also likely to ameliorate other facets of his personality disorder.

It is a chain reaction: controlling one’s eating disorders leads to a better regulation of one’s sense of self-worth, self-confidence, and self-esteem. Successfully coping with one challenge – the eating disorder – generates a feeling of inner strength and results in better social functioning and an enhanced sense of well-being.

When a patient has a personality disorder and an eating disorder, the therapist would do well to first tackle the eating disorder. Personality disorders are intricate and intractable. They are rarely curable (though certain aspects, like obsessive-compulsive behaviours, or depression can be ameliorated with medication or modified). The treatment of personality disorders requires enormous, persistent and continuous investment of resources of every kind by everyone involved.

From the patient’s point of view, the treatment of her personality disorder is not an efficient allocation of scarce mental resources. Neither are personality disorders the real threat. If one’s personality disorder is cured but one’s eating disorders are left untouched, one might die (though mentally healthy)…

An eating disorder is both a signal of distress (“I wish to die, I feel so bad, somebody help me”) and a message: “I think I lost control. I am very afraid of losing control. I will control my food intake and discharge. This way I can control at least ONE aspect of my life.”

This is where we can and should begin to help the patient – by letting her regain control of her life. The family or other supporting figures must think what they can do to make the patient feel that she is in control, that she is managing things her own way, that she is contributing, has her own schedules, her own agenda, and that she, her needs, preferences, and choices matter.

Eating disorders indicate the strong combined activity of an underlying sense of lack of personal autonomy and an underlying sense of lack of self-control. The patient feels inordinately, paralyzingly helpless and ineffective. His eating disorders are an effort to exert and reassert mastery over his own life.

At this early stage, the patient is unable to differentiate his own feelings and needs from those of others. His cognitive and perceptual distortions and deficits (for instance, regarding his body image – known as a somatoform disorder) only increase his feeling of personal ineffectualness and his need to exercise even more self-control (by way of his diet).

The patient does not trust himself in the slightest. He rightly considers himself to be his worst enemy, a mortal adversary. Therefore, any effort to collaborate with the patient against his own disorder is perceived by the patient as self-destructive. The patient is emotionally invested in his disorder – his vestigial mode of self-control.

The patient views the world in terms of black and white, of absolutes (“splitting”). Thus, he cannot let go even to a very small degree. He is constantly anxious. This is why he finds it impossible to form relationships: he mistrusts (himself and by extension others), he does not want to become an adult, he does not enjoy sex or love (which both entail a modicum of loss of control).

All this leads to a chronic absence of self-esteem. These patients like their disorder. Their eating disorder is their only achievement. Otherwise they are ashamed of themselves and disgusted by their shortcomings (expressed through the distaste with which they hold their body).

Eating disorders are amenable to treatment, though comorbidity with a personality disorder presages a poorer prognosis. The patient should be referred to talk therapy, medication, and enrol in online and offline support groups (such as Overeaters Anonymous).

Recovery prognosis is good after 2 years of treatment and support. The family must be heavily involved in the therapeutic process. Family dynamics usually contribute to the development of such disorders.

In short: medication, cognitive or behavioural therapy, psychodynamic therapy and family therapy ought to do it.

The change in the patient following a successful course of treatment is VERY MARKED. His major depression disappears together with his sleeping disorders. He becomes socially active again and gets a life. His personality disorder might make it difficult for him – but, in isolation, without the exacerbating circumstances of his other disorders, he finds it much easier to cope with.

Patients with eating disorders may be in mortal danger. Their behaviour is ruining their bodies relentlessly and inexorably. They might attempt suicide. They might do drugs. It is only a question of time. The therapist’s goal is to buy them that time. The older they get, the more experienced they become, the more their body chemistry changes with age – the better their chances to survive and thrive.