Autism or Autism Spectrum Disorder
An Introduction
Autism also known as Autism Spectrum Disorder (ASD) is prevalent among 1 in 100 children (Zeidan J., 2022). Autism is a neurodevelopmental disorder which in simple terms means that a child’s growth and development of the brain is affected due to a condition or a group of conditions which impacts their everyday functioning. A child with a “spectrum disorder” exhibits distinctive behavioural patterns and a range in the intensity of their symptoms (from low functioning to high functioning). As an example, some kids with intellect levels below average may struggle to learn and communicate, but others may display traits of intelligence ranging from normal to high. While some people may have little trouble adjusting to social situations, others may find it difficult to use common sense in their daily lives. Because of this, autism is distinct and challenging to comprehend and recognise. It is however noteworthy that in the past two decades, research and updated training programs for professionals have led to better understanding and management of autism among children.
Diagnosis, Signs & Symptoms and Levels
Parents, carers, and clinical psychologists can spot the early signs of autism in children as young as one year old. It can occasionally be identified in children as early as 18 months old by a skilled mental health expert. At the age of 3, the symptoms are typically more obvious and consistent. When the child attends school, interacts with peers, and participates in activities, it becomes clearly apparent.
Below mentioned are the certain signs & symptoms and level of the disorder.
Certain aforementioned points can also be noted in certain individuals without ASD but for people with ASD, the characteristics can make life very challenging. Each domain may have a range of levels, which the professional can use as a reference to determine the level of assistance or intervention needed for each child’s particular functioning.
Causes and Risks
- Family History – Children with parents, relatives of parents or an older sibling having features of ASD
- Birth Complications – Babies born pre-term in the second trimester, low birth weight or other complications at birth
- Pregnancy or being born to older parents.
- Genetic conditions such as Down syndrome or Fragile X syndrome
- Environmental Factors – Child-bearing women consuming or exposed to drugs, chemicals, alcohol or other substances.
In conclusion, autism can range from mild, which can be managed with the help of the necessary interventions without negatively affecting daily functioning, to severe, which necessitates the use of specialised facilities to meet the child’s demands. Therefore, the treatment plans typically call for interventions from a variety of professionals who can aid in the child’s long-term holistic development. It may be said that ASD is manageable if early intervention is initiated.
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Attention Deficit Hyperactivity Disorder (ADHD)
An Introduction
Is it rare? No. It is one of the most prevalent neurodevelopmental disorders in childhood, with a global frequency of roughly 5%, according to the Diagnostic Statistical Manual-5. Again, to be clear, there are varying levels of severity for each and every medical disorder, including ADHD. A 2016 CDC (Centers for Disease Control and Prevention) study found that ADHD is typically screened/diagnosed in children between the ages of 2 and 17. To ensure more acceptance of this disorder, there are two things we would like to make clear before going any farther and going into more detail. One, kids can be trained to behave in desired manner. Kids do not act in a certain manner or disobey out of purpose all the time. Sometimes there are underlying factors which are going to be discussed extensively below. Second, medicine is not the only or the best therapeutic option. Sometimes a combination of medications and other forms of psychoeducation, behavioral management, etc., can help. In other circumstances, it cannot work.
Then, in simple terms, what is ADHD? ADHD is a neurodevelopmental disorder characterized by majorly three types of difficulties, including maintaining attention or focus, hyperactivity, and impulsive actions. It mostly affects how people behave, causing them to act impulsively, appear or feel restless, and have trouble focusing. Early in childhood, the signs might be seen, but they often become more obvious when changes or triggers occur, especially after entering school.
Symptoms and Signs
A professional makes a diagnosis when it persists and is visible for at least six months in a variety of contexts, including school, home, playground/work, and/or social connections and causes considerable difficulties with sitting still, patience, focus, organization, impulsivity, etc. The following figure illustrates the symptoms of the three primary forms of ADHD:
Causes
- Biological – Genetic, Premature birth, difficult pregnancy, post birth challenges like lower weight, head injuries during delivery etc.
- Pre-Natal Factors – Smoking, alcohol or drug abuse during pregnancy, accidents if any etc.
- Environmental Factors – Exposure to hazardous chemicals like lead, accidental brain or head injuries etc.
So, should we be afraid of ADHD? No. Even though an ADHD diagnosis is nothing to be terrified of, it does necessitate expert care. Although mild to moderate cases are not very uncommon, they run the risk of going misdiagnosed and developing into other comorbid conditions, which would make it even more difficult for the sufferer to get the right kind of medical care. The ability to regulate mood swings and other impulsive harmful behaviors can be learned by using behavioral therapies. There is no harm in going to a professional for a regular checkup when certain symptoms are noticeable for a period of at least 6 months causing difficulty in adapting and adjusting to normal life activities.Why do we say so? because when ADHD causes dysfunctionalities in adulthood, it requires extra time and effort for an individual to overcome the behavioral issues causing more internal challenges and other negative coping mechanisms. So the sooner behavioral modifications are made and medical help is sought, the better.
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Borderline Personality Disorder
Before you start reading this article to make yourself aware about what Borderline Personality Disorder is, I would request you to take out 2 minutes to go through the complete article first with an open mind and not with a mindset of self-diagnosis.
One of the most frequently misdiagnosed mental health conditions is borderline personality disorder, which is why the above request was made to you. According to National Institute ofMental Health (NIMH) statistics, 1.6% of the adult population has a BPD diagnosis. This may sound less, but it’s actually a lot. According to the NEABPD, more than half of adults experience self-harm triggers during their lifetime. As we noted earlier, BPD is frequently misdiagnosed because it is either mistaken for other, more common mental health conditions like depression, anxiety, or bipolar disorder, or it is present together with other comorbid conditions, which lowers its statistical prevalence. According to statistics, BPD is fairly prevalent at various intensities. It is also evident that the ratio of women to men is 3:1. The ratio indicated in the research is, however, cast in doubt because males seek support less frequently than women do in the world in which we live.
To reiterate, we are attempting to highlight that mental health disorders are very common and that it is normal to feel overwhelmed, afraid, and lonely all at once by presenting information and data here along with prevalence figures. In reality, there are many people going through it; they may just be misinformed or not aware of it. Finding the correct assistance and knowledge speeds up the healing process. What then is BPD?
It cannot be seen, but it can be felt by an individual, just like all mental health challenges. Let’s first understand a core feature of BPD called emotional dysregulation? What happens when an air conditioner’s internal mechanism is hampered. It cannot keep a balance and causes rapid cooling or strong heating. An individual with a diagnosis of BPD has a similar situation on the emotional front. You may experience great emotions in a moment, sometimes for the other person and sometimes for yourself, which could cause erratic conduct. However, it is noteworthy that the diagnosis of BPD is not made based on solely experiencing or not experiencing this single symptom. There is a cluster of symptoms that clinicians typically examine you for.
Signs and Symptoms
To move ahead let’s see some of the most prevalent signs and symptoms.
· Identity crisis or persistently unstable sense of self or self image.
· Overwhelming feelings of emptiness or void or loneliness
· Fear of abandonment and makes frantic efforts to avoid real or imagined situations
· Pathological personality traits like intense mood swings, short-lived bouts of anxiety, reckless and impulsive behaviors.
· Impairment in maintaining relationships and managing impulses showing reactions like temper issues (yelling, screaming, physical fights etc).
· Recurrent self-harming episodes
· Impulsivity manifested in more self-damaging behaviors like reckless driving, substance abuse, risky sexual activities, outbursts of violence etc.
· Emotional Instability triggered internally or by external factors.
· Hypersensitivity, overwhelm, intense emotions of guilt, inadequacy etc.
Please note, these are felt by all humans irrespective of the state. BPD is a mental health condition whereby an individual has a long-term pattern of erratic, turbulent and unstable emotions leading to impulsive behaviors and chaotic relationships with self (intrapersonal) and others (interpersonal).
Causes
· Childhood Traumatic Experiences – History of physical, emotional or sexual abuse; trauma or being a part of dysfunctional family units, disrupted family life.
· Communication Issues – In the family, caregiver, social circle
· Biological – History of either or both parents or family members showing symptoms of disorder.
· Comorbidity – Prevalence of mental health disorders like eating, mood, substance, anxiety, personality (to name a few) leading to its trigger.
In conclusion, borderline personality disorder is not that uncommon, can be misdiagnosed, and occasionally takes a lot of time to be diagnosed only when an individual starts experiencing stark symptoms that are affecting their daily functioning in various spheres of life and causing distress to people around them regardless of the context of the individual is in. Though it is serious to an extent, it does not carry a life sentence. Similar to an air conditioner, it needs to be oiled and fixed using a therapeutic approach in order to resume regular operation. With regular therapeutic intervention, around half of those who seek the appropriate professional assistance and work on themselves exhibited only very slight indications of the criteria for psychopathology.
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Obsessive-Compulsive Disorder (OCD) – Symptoms and Causes
“I like my room clean, Do I have OCD?”
OCD: An Introduction
World Health Organisation (WHO) states that OCD falls in the ranking of top 10 most disabling illnesses. Does this mean we are trying to scare you here? No. The reason behind sharing statistics is to share that it is common. Also concern, shame or stigma should not stop you from saying it out loud and seeking the right support.
The onset can be in the early childhood, teenage years or young adulthood. Its impact on an individual’s functioning and its categorization as a psychological ailment depends on its level of severity and comorbidity with other health challenges. Before we dive deeper, let us first see in simple terms what actually is obsessive traits vs obsessive compulsive disorder.
‘I like my room clean, I have OCD’, said a friend. But the friend can carry on with his everyday life events if the things are a little messy for a while or a day or two. Now does the friend suffer from OCD?
Before moving further let’s understand what happens in OCD. It features a pattern of recurring and persistent unwanted thoughts, impulses, ideas, urges, images, sensations termed as obsessions that feel outside of a person’s control. These obsessive patterns could lead to uncomfortable emotions of distress, disgust, uncertainty, doubt, anxiety and fear. In order to suppress these emotions, when the individual does repetitive behaviors (like washing, organizing, inspections etc), rituals or mental acts (like counting, chanting, reiterating statements etc) termed as compulsions, it leads to temporary relief from those obsessions. Which in future becomes a reinforcement of negative behaviors, making these compulsions take over everyday normal routine.
So our friend above would not have been suffering with obsessive traits whereby using reasoning and logic, the room could stay messy for a while. OCD becomes a cause of concern and psychological disorder when an individual loses his/her ability to use reasoning or logic but gets stuck in the vicious cycle, making the normal routine impossible or very difficult without compulsive actions.
A simpler diagrammatic representation of OCD cycle showing how the severity level increases if interventions do not take place.
The question again arises whether people with OCD only get involved in compulsive acts? As mentioned earlier, some individuals might indulge into few compulsive acts like arranging things in a particular order whenever possible because they like to see things in a particular order as a part of their personality trait but would not torture themselves or experience immense stress for the same. On the other hand, people with OCD believe that those acts/rituals are absolutely necessary to reduce negative consequences or escape anxiety while the obsessions are active and seemingly control their lives.
Causes of OCD
Some of the common causes of OCD are:
· Genetic or Family History – A history or genetic disposition makes an individual more susceptible to having a disorder from triggers causing distress. Just like a few physiological disorders, OCD may also be carried from generation to generation.
· Comorbidity – Sometimes the prevalence of depression or anxiety or a few other psychological disorders exposes an individual to fall prey into the cycle of OCD on pretext of temporary relief.
· Biological – The neural pathways and body’s own natural chemistry also pave the way to developing OCD. Studies are still being conducted to prove the same.
· Observational Learning – Obsessive Fears and Compulsive acts can be seen and learned from the external environment. There is a possibility of a child learning these compulsions from a significant other.
· Cultural factor – Distorted beliefs may trigger distress, maintain and reinforce symptoms associated with OCD.
Is OCD Treatable?
OCD can be managed, just like any other medical illness (such as diabetes and hypertension). Interventions with medicine and psychotherapy make up the majority of management. Clinical psychologists use psychotherapeutic behavioral therapies to help patients control their stress, recurring obsessive tendencies, and negative belief systems while also assisting them in leading generally healthy lives. A psychiatrist will perform pharmacological intervention, which involves using medications to manage OCD symptoms.
To sum it up, quoting Amelia Diane Coombs from Exactly Where You need to be,
“My OCD is a speed bump, not a barrier to happiness.”
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Depression – What is it?
An Introduction
‘I am Fine’. That is what the mouth utters when someone checks on us. Most of us want to talk about it, sometimes scream internally, yell but end up saying the most acceptable response, I am fine. Depression is seen as an internal demon which should be hidden under a mask. But why? Is depression that uncommon?
According to WHO, 5% of adults globally suffer from depression. It is that common when the correct diagnosis is made. One of the major challenges or barriers of correct diagnosis is lack of trained healthcare professionals, social stigmas and lack of resources available.
To make it easier for you to understand what depression is and the changes it causes inside out, here is a diagrammatic representation of severity level and symptoms for reference.
Seeing the symptom chart, you must be considering you also have signs of depression. To make it more clear, in depression, a person experiences most of the signs and symptoms most of the day, almost every day for atleast two weeks. A person cannot and should not self-diagnose. Instead if the signs seem to be prevalent, a mental health professional (clinical psychologist/psychiatrist) should be contacted to diagnose, categorise in mild, moderate or severe category after taking into consideration current life stressors and individual’s functioning.
Common Factors leading to depression
Is mood fluctuation normal? – Yes, mood fluctuations are completely normal. No one person can be happy/sad all the time. It’s a blend of complex interaction of social, psychological and biological factors.
· Unmet needs – Unmet needs in the areas of social, emotional, physical like food, housing, social support (family/friends/community), inclusion in society, respect, occupation, education etc can lead a person to question life and feeling discontented leading to further deterioration.
· Genetic History – A family history of any psychiatric disorder puts an individual at a risk of being affected by it even with small triggers in the future. The genetics are not as easily diagnosed or straightforward as other physical health conditions. The reason being psychological disorders are so many times left undiagnosed.
· Gender – Women are more prone to be affected by depression than men because of the biological composition, hormones and changes that take place within their bodies. This does not mean men cannot get depression, women can be easily triggered with life changes.
· Medications and Physical Disorders – Sometimes while seeking treatment, some medications may trigger mood fluctuations.
· Major Life Events or Conflicts – Major life changing events which may be considered positive (like job, marriage, moving to a new place etc) or negative (divorce, loss of a loved one, disputes in work or personal life etc) can lead to increased stress and changes in chemical composition in the body.
· Neurotransmitters and Nutrition – The mind-body balance is essential. Sometimes any chemical imbalance or deficiency may also trigger mood fluctuation and after blending with other external factors, it can lead to features of depression.
Diagnosis and Treatment
The experience and context of depression for each individual is different. It does not target any individual on the basis of their past, karma or economic status.
An individual, just like other physical health conditions, can manage the signs and symptoms of depression by reaching out to a trained, licensed professional from the field of mental health (clinical psychologists and psychiatrists).
Management of depression includes either psychological therapies or a blend of psychological and pharmacological management. A clinical psychologist takes care of the non-pharmacological management by focusing on holistic and eclectic talk therapy approaches, helping an individual become equipped with tools and skills to handle distress and for an overall healthy functioning. A Psychiatrist manages the pharmacological aspect of management with the help of medicines.
When is Depression not Treatable?
· Resistance from an individual to label any negative emotion/action/thoughts with psychiatric terminology under the guidance of the professional and not seeking help.
· Self-labelling as defective for feeling or experiencing negative emotions inside and out.
To sum it up, quoting David Mitchell from Cloud Atlas, what we professionals see depression as:
“You say you’re ‘depressed’ – all I see is resilience. You are allowed to feel messed up and inside out. It doesn’t mean you’re defective – it just means you’re human.”
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