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5 Important Concepts in Social Psychology

Social psychology is a branch of psychology concerned with how social influences affect how people think, feel, and act. The way we perceive ourselves in relation to the rest of the world plays an important role in our choices, behaviors, and beliefs. Conversely, the opinions of others also impact our behavior and the way we view ourselves.

Understanding social psychology can be useful for many reasons. First, we can better understand how groups impact our choices and actions. There are some basic aspects of social behavior that play a large role in our actions and how we see ourselves.

Social Behavior Is Goal-Oriented

Our interactions serve goals or fulfill needs. Some common goals or needs include the need for social ties, the desire to understand ourselves and others, the wish to gain or maintain status or protection, and the need to attract companions.

The way people behave is often driven by the desire to fulfill these needs.1 People seek friends and romantic partners, strive to gain social status, and attempt to understand the motivations that guide other people’s behaviors.

Situations Help Determine Outcome

In many instances, people behave very differently depending upon the situation. To fully understand why people do the things they do, it is essential to look at individual characteristics, the situation and its context, and the interactions among all these variables.

For example, someone who is normally quiet and reserved might become much more outgoing when placed in some type of leadership role. Another example is how people sometimes behave differently in groups than they would if they were by themselves. Environmental and situational variables play an important role and have a strong influence on our behavior.

Social psychology allows us to gain a greater appreciation for how our social perceptions affect our interactions with other people.

Social Situations Form Self-Concept

Our social interactions help form our self-concept and our perceptions. One method of forming self-concept is through the reflected appraisal process,2 in which we imagine how other people see us. Another method is through the social comparison process, whereby we consider how we compare to other people in our peer group.

Sometimes we engage in upward social comparison where we rate ourselves against people who are better off than us in some way. In other instances, we might engage in downward social comparison where we contrast our own abilities to those of others who are less capable.

We Analyze the Behavior of Others

One common phenomenon is the expectation confirmation, where we tend to ignore unexpected attributes and look for evidence that confirms our preexisting beliefs about others.4 This helps simplify our worldview, but it also skews our perception and can contribute to stereotyping.

If you expect people to behave in a certain way, you might look for examples that confirm your belief while at the same time ignoring evidence that conflicts with your existing opinions.

We Believe Behavior Reflects Personality

Another influence on our perceptions of other people can be explained by the theory of correspondent inferences.5 This occurs when we infer that the actions and behaviors of others correspond to their intentions and personalities. For example, if we see a woman helping an elderly person cross the street, we might assume that she is kind-hearted. While behavior can be informative, it can also be misleading.

If we have limited interaction with someone, the behavior we see may be atypical or caused by the specific situation rather than by the person’s overriding dispositional characteristics. In the previous example, the woman might only be helping the elderly person because she has been employed to do so instead of out of the kindness of her heart.

What is the Importance of Social Psychology in Society?

 The importance of social psychology is shown in all the interactive aspects of the individual’s social life and all the environments in which he coexists, which can affect the individual’s interactions and personality.
As social psychology studies the behavior of individuals and groups, everyone who deals with and communicates with different community groups needs this science; to understand and guide individuals and to study various responses within the community.
For example, the teacher needs in his class to analyze the students’ personalities and their interdependence and understand the relationships between them, and strategies that fit the patterns and mechanisms to convince them for a particular idea, in addition to the partnership among themselves and cooperation and competition and behaviors based on their presence within the group.
Social psychology also requires social specialists to understand the philosophy of society, the secrets of its composition, the relative appearance, and absence of phenomena, and link to societal behaviors.
The individual in his daily life is able to explain his behavior and self-behavior around him properly, understanding the interaction and harmony that takes place between the individual among others.
Thus the understanding of social and cultural being, which in turn determines the expected behavioral patterns in different social attitudes, in addition to this science, gives the individual the ability to differentiate between people, the possibility of accepting a certain category and move away from another category.
The importance of social psychology was highlighted directly in daily life situations, in addition to its great importance in the field of life of the international community and the world and social issues experienced by people from situations of war, slavery, freedom, and security.  These are separated as follows:

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What is the Importance of Social Psychology in Society?

 The importance of social psychology is shown in all the interactive aspects of the individual’s social life and all the environments in which he coexists, which can affect the individual’s interactions and personality.
As social psychology studies the behavior of individuals and groups, everyone who deals with and communicates with different community groups needs this science; to understand and guide individuals and to study various responses within the community.
For example, the teacher needs in his class to analyze the students’ personalities and their interdependence and understand the relationships between them, and strategies that fit the patterns and mechanisms to convince them for a particular idea, in addition to the partnership among themselves and cooperation and competition and behaviors based on their presence within the group.
Social psychology also requires social specialists to understand the philosophy of society, the secrets of its composition, the relative appearance, and absence of phenomena, and link to societal behaviors.
The individual in his daily life is able to explain his behavior and self-behavior around him properly, understanding the interaction and harmony that takes place between the individual among others.
Thus the understanding of social and cultural being, which in turn determines the expected behavioral patterns in different social attitudes, in addition to this science, gives the individual the ability to differentiate between people, the possibility of accepting a certain category and move away from another category.
The importance of social psychology was highlighted directly in daily life situations, in addition to its great importance in the field of life of the international community and the world and social issues experienced by people from situations of war, slavery, freedom, and security.  These are separated as follows:

Practical importance

All people who engage in groups and individuals need to study the principles of social psychology continuously in order to understand and guide social behaviors. The importance of these groups is as follows:
Teacher: The teacher in the classroom needs to understand the social-behavioral characteristics of the students as a micro-social environment based on the relationships and interactions among their members, as well as the importance of identifying the steps of socialization that are manifested in the behavioral interaction among individuals such as competition, cooperation, learning, and collective thinking.
Social Specialist: The importance of social psychology to social specialists in understanding and studying social organization and its orientation towards social cohesion, trends, intolerance, and leadership.
Businessmen: Social psychology helps to understand the nature of the laws of human relations that exist between categories of workers in a given domain, and the important relationship between the level of moral spirit and mental health and the level of production and achievement.
Normal Human: The study of social psychology in everyday life helps to achieve as much as possible the individual’s understanding of his own behavior and the external behavior of other individuals, thus understanding the dynamics of interaction and communication with others, as well as the cultural and social backgrounds in which patterns and behaviors are determined. Good judgment in using the proper way to deal with others, either by accepting and sacrificing in some situations or with distaste and dislike in other situations.

Global importance

Since the first emergence of social psychology, it deals with future issues by warning against crises and inevitable problems, optimism about the sound construction of this future, and providing suggestions and predictive and remedial plans for economic and political problems such as the problems of war and aggression and its consequences and global financial crises. Global Inclusiveness seeks to create a society of excellence in which the opportunities available to individuals in all fields are equal to all members of society.
It also has an important role in spreading the highest human ideals among individuals within one society in the effective study of psycho-social phenomena, research, and experimental study. The following points can be summarized as follows:
Warning of future problems: It is possible to warn against future problems and crises by predicting initial signs and symptoms that may indicate the possibility of a particular problem in a given area and warning people without intervening in the course of events. However, it is possible to direct social activity in light of current events.
Building the future: Human scientists emphasize that a person can change the course of his life by directing his activities appropriately with achieving his goals and solving problems. Just as human beings used biological sciences to raise the level of health efficiency, it is possible to use social psychology to seek social justice and the future.
Addressing political and economic problems: These problems arise as a result of the imbalance in the distribution of tasks, work, resources, and efforts in appropriate activities.
This results from ignorance of the understanding of the social characteristics of man, which is the subject of psychological and social research, which in turn creates the basic laws and principles of social life together.

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Cognitive development is the construction of thought processes, including remembering, problem solving, and decision-making, from childhood through adolescence to adulthood.

It was once believed that infants lacked the ability to think or form complex ideas and remained without cognition until they learned language. It is now known that babies are aware of their surroundings and interested in exploration from the time they are born. From birth, babies begin to actively learn. They gather, sort, and process information from around them, using the data to develop perception and thinking skills.

Cognitive development refers to how a person perceives, thinks, and gains understanding of his or her world through the interaction of genetic and learned factors. Among the areas of cognitive development are information processing, intelligence , reasoning, language development , and memory.

The 4 Stages of Cognitive Development

Jean Piaget’s theory of cognitive development suggests that children move through four different stages of mental development. His theory focuses not only on understanding how children acquire knowledge, but also on understanding the nature of intelligence.1 Piaget’s stages are:

• Sensorimotor stage: birth to 2 years
• Preoperational stage: ages 2 to 7
• Concrete operational stage: ages 7 to 11
• Formal operational stage: ages 12 and up

Piaget believed that children take an active role in the learning process, acting much like little scientists as they perform experiments, make observations, and learn about the world. As kids interact with the world around them, they continually add new knowledge, build upon existing knowledge, and adapt previously held ideas to accommodate new information.

How Piaget Developed the Theory

Piaget was born in Switzerland in the late 1800s and was a precocious student, publishing his first scientific paper when he was just 11 years old. His early exposure to the intellectual development of children came when he worked as an assistant to Alfred Binet and Theodore Simon as they worked to standardize their famous IQ test.

Much of Piaget’s interest in the cognitive development of children was inspired by his observations of his own nephew and daughter. These observations reinforced his budding hypothesis that children’s minds were not merely smaller versions of adult minds.

Up until this point in history, children were largely treated simply as smaller versions of adults. Piaget was one of the first to identify that the way that children think is different from the way adults think.

Instead, he proposed, intelligence is something that grows and develops through a series of stages. Older children do not just think more quickly than younger children, he suggested. Instead, there are both qualitative and quantitative differences between the thinking of young children versus older children.

Based on his observations, he concluded that children were not less intelligent than adults, they simply think differently. Albert Einstein called Piaget’s discovery “so simple only a genius could have thought of it.”

Piaget’s stage theory describes the cognitive development of children. Cognitive development involves changes in cognitive process and abilities.2 In Piaget’s view, early cognitive development involves processes based upon actions and later progresses to changes in mental operations.

The Stages

Through his observations of his children, Piaget developed a stage theory of intellectual development that included four distinct stages:

The Sensorimotor Stage

Ages: Birth to 2 Years

Major Characteristics and Developmental Changes:

• The infant knows the world through their movements and sensations
• Children learn about the world through basic actions such as sucking, grasping, looking, and listening
• Infants learn that things continue to exist even though they cannot be seen (object permanence)
• They are separate beings from the people and objects around them
• They realize that their actions can cause things to happen in the world around them

During this earliest stage of cognitive development, infants and toddlers acquire knowledge through sensory experiences and manipulating objects. A child’s entire experience at the earliest period of this stage occurs through basic reflexes, senses, and motor responses.

It is during the sensorimotor stage that children go through a period of dramatic growth and learning. As kids interact with their environment, they are continually making new discoveries about how the world works.

The cognitive development that occurs during this period takes place over a relatively short period of time and involves a great deal of growth. Children not only learn how to perform physical actions such as crawling and walking; they also learn a great deal about language from the people with whom they interact. Piaget also broke this stage down into a number of different substages. It is during the final part of the sensorimotor stage that early representational thought emerges.

Piaget believed that developing object permanence or object constancy, the understanding that objects continue to exist even when they cannot be seen, was an important element at this point of development.

By learning that objects are separate and distinct entities and that they have an existence of their own outside of individual perception, children are then able to begin to attach names and words to objects. The Sensorimotor Stage of Cognitive Development

The Preoperational Stage

Ages: 2 to 7 Years

Major Characteristics and Developmental Changes:

• Children begin to think symbolically and learn to use words and pictures to represent objects.
• Children at this stage tend to be egocentric and struggle to see things from the perspective of others.
• While they are getting better with language and thinking, they still tend to think about things in very concrete terms.

The foundations of language development may have been laid during the previous stage, but it is the emergence of language that is one of the major hallmarks of the preoperational stage of development.3

Children become much more skilled at pretend play during this stage of development, yet continue to think very concretely about the world around them. 

At this stage, kids learn through pretend play but still struggle with logic and taking the point of view of other people. They also often struggle with understanding the idea of constancy.
For example, a researcher might take a lump of clay, divide it into two equal pieces, and then give a child the choice between two pieces of clay to play with. One piece of clay is rolled into a compact ball while the other is smashed into a flat pancake shape. Since the flat shape looks larger, the preoperational child will likely choose that piece even though the two pieces are exactly the same size. Preoperational Stage of Cognitive Development in Young Children

The Concrete Operational Stage

Ages: 7 to 11 Years

Major Characteristics and Developmental Changes

• During this stage, children begin to thinking logically about concrete events
• They begin to understand the concept of conservation; that the amount of liquid in a short, wide cup is equal to that in a tall, skinny glass, for example
• Their thinking becomes more logical and organized, but still very concrete
• Children begin using inductive logic, or reasoning from specific information to a general principle

While children are still very concrete and literal in their thinking at this point in development, they become much more adept at using logic.2 The egocentrism of the previous stage begins to disappear as kids become better at thinking about how other people might view a situation.

While thinking becomes much more logical during the concrete operational state, it can also be very rigid. Kids at this point in development tend to struggle with abstract and hypothetical concepts.

During this stage, children also become less egocentric and begin to think about how other people might think and feel. Kids in the concrete operational stage also begin to understand that their thoughts are unique to them and that not everyone else necessarily shares their thoughts, feelings, and opinions. The Concrete Operational Stage in Cognitive Development

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The Formal Operational Stage

Ages: 12 and Up

Major Characteristics and Developmental Changes:

• At this stage, the adolescent or young adult begins to think abstractly and reason about hypothetical problems
• Abstract thought emerges
• Teens begin to think more about moral, philosophical, ethical, social, and political issues that require theoretical and abstract reasoning
• Begin to use deductive logic, or reasoning from a general principle to specific information

The final stage of Piaget’s theory involves an increase in logic, the ability to use deductive reasoning, and an understanding of abstract ideas.3 At this point, people become capable of seeing multiple potential solutions to problems and think more scientifically about the world around them.

The ability to thinking about abstract ideas and situations is the key hallmark of the formal operational stage of cognitive development. The ability to systematically plan for the future and reason about hypothetical situations are also critical abilities that emerge during this stage. 

It is important to note that Piaget did not view children’s intellectual development as a quantitative process; that is, kids do not just add more information and knowledge to their existing knowledge as they get older. Instead, Piaget suggested that there is a qualitative change in how children think as they gradually process through these four stages.4 A child at age 7 doesn’t just have more information about the world than he did at age 2; there is a fundamental change in how he thinks about the world. Formal Operational Stage of Cognitive Development

Important Concepts

To better understand some of the things that happen during cognitive development, it is important first to examine a few of the important ideas and concepts introduced by Piaget.

The following are some of the factors that influence how children learn and grow:

Schemas

A schema describes both the mental and physical actions involved in understanding and knowing. Schemas are categories of knowledge that help us to interpret and understand the world.

In Piaget’s view, a schema includes both a category of knowledge and the process of obtaining that knowledge.3 As experiences happen, this new information is used to modify, add to, or change previously existing schemas.

For example, a child may have a schema about a type of animal, such as a dog. If the child’s sole experience has been with small dogs, a child might believe that all dogs are small, furry, and have four legs. Suppose then that the child encounters an enormous dog. The child will take in this new information, modifying the previously existing schema to include these new observations.

Assimilation

The process of taking in new information into our already existing schemas is known as assimilation. The process is somewhat subjective because we tend to modify experiences and information slightly to fit in with our preexisting beliefs. In the example above, seeing a dog and labeling it “dog” is a case of assimilating the animal into the child’s dog schema. Assimilation and Jean Piaget’s Adaptation Process

Accommodation

Another part of adaptation involves changing or altering our existing schemas in light of new information, a process known as accommodation. Accommodation involves modifying existing schemas, or ideas, as a result of new information or new experiences.5 New schemas may also be developed during this process.

Equilibration

Piaget believed that all children try to strike a balance between assimilation and accommodation, which is achieved through a mechanism Piaget called equilibration. As children progress through the stages of cognitive development, it is important to maintain a balance between applying previous knowledge (assimilation) and changing behavior to account for new knowledge (accommodation). Equilibration helps explain how children can move from one stage of thought to the next.



Cognitive development
Age	Activity
One month	Watches person when spoken to.
Two months	Smiles at familiar person talking. Begins to follow moving person with eyes.
Four months	Shows interest in bottle, breast, familiar toy, or new surroundings.
Five months	Smiles at own image in mirror. Looks for fallen objects.
Six months	May stick out tongue in imitation. Laughs at peekaboo game. Vocalizes at mirror image. May act shy around strangers.
Seven months	Responds to own name. Tries to establish contact with a person by cough or other noise.
Eight months	Reaches for toys out of reach. Responds to “no.”
Nine months	Shows likes and dislikes. May try to prevent face-washing or other activity that is disliked. Shows excitement and interest in foods or toys that are well-liked.
Ten months	Starts to understand some words. Waves bye-bye. Holds out arm or leg for dressing.
Eleven months	Repeats performance that is laughed at. Likes repetitive play. Shows interest in books.
Twelve months	May understand some “where is…?” questions. May kiss on request.
Fifteen months	Asks for objects by pointing. Starting to feed self. Negativism begins.
Eighteen months	Points to familiar objects when asked “where is…?” Mimics familiar adult activities. Know some body parts. Obeys two or three simple orders.
Two years	Names a few familiar objects. Draws with crayons. Obeys found simple orders. Participates in parallel play.
Two-and-a-half years	Names several common objects. Begins to take interest in sex organs. Gives full names. Helps to put things away. Peak of negativism.
Three years	Constantly asks questions. May count to 10. Begins to draw specific objects. Dresses and undresses doll. Participates in cooperative play. Talks about things that have happened.
Four years	May make up silly words and stories. Beginning to draw pictures that represent familiar things. Pretends to read and write. May recognize a few common words, such as own name.
Five years	Can recognize and reproduce many shapes, letters, and numbers. Tells long stories. Begins to understand the difference between real events and make-believe ones. Asks meaning of words
SOURCE : Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, 5th ed . and Child Development Institute, http://www.childdevelopmentinfo.com.

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Dissociative disorders are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. People with dissociative disorders escape reality in ways that are involuntary and unhealthy and cause problems with functioning in everyday life.

Dissociative disorders usually develop as a reaction to trauma and help keep difficult memories at bay. Symptoms — ranging from amnesia to alternate identities — depend in part on the type of dissociative disorder you have. Times of stress can temporarily worsen symptoms, making them more obvious.

Treatment for dissociative disorders may include talk therapy (psychotherapy) and medication. Although treating dissociative disorders can be difficult, many people learn new ways of coping and lead healthy, productive lives.

Causes

Dissociative disorders usually develop as a way to cope with trauma. The disorders most often form in children subjected to long-term physical, sexual or emotional abuse or, less often, a home environment that’s frightening or highly unpredictable. The stress of war or natural disasters also can bring on dissociative disorders.

Personal identity is still forming during childhood. So a child is more able than an adult to step outside of himself or herself and observe trauma as though it’s happening to a different person. A child who learns to dissociate in order to endure a traumatic experience may use this coping mechanism in response to stressful situations throughout life.

Symptoms

Signs and symptoms depend on the type of dissociative disorders you have, but may include:

• Memory loss (amnesia) of certain time periods, events, people and personal information
• A sense of being detached from yourself and your emotions
• A perception of the people and things around you as distorted and unreal
• A blurred sense of identity
• Significant stress or problems in your relationships, work or other important areas of your life
• Inability to cope well with emotional or professional stress
• Mental health problems, such as depression, anxiety, and suicidal thoughts and behaviors

There are three major dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association:

• Dissociative amnesia. The main symptom is memory loss that’s more severe than normal forgetfulness and that can’t be explained by a medical condition. You can’t recall information about yourself or events and people in your life, especially from a traumatic time. Dissociative amnesia can be specific to events in a certain time, such as intense combat, or more rarely, can involve complete loss of memory about yourself. It may sometimes involve travel or confused wandering away from your life (dissociative fugue). An episode of amnesia usually occurs suddenly and may last minutes, hours, or rarely, months or years.
• Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder is characterized by “switching” to alternate identities. You may feel the presence of two or more people talking or living inside your head, and you may feel as though you’re possessed by other identities. Each identity may have a unique name, personal history and characteristics, including obvious differences in voice, gender, mannerisms and even such physical qualities as the need for eyeglasses. There also are differences in how familiar each identity is with the others. People with dissociative identity disorder typically also have dissociative amnesia and often have dissociative fugue.
• Depersonalization-derealization disorder. This involves an ongoing or episodic sense of detachment or being outside yourself — observing your actions, feelings, thoughts and self from a distance as though watching a movie (depersonalization). Other people and things around you may feel detached and foggy or dreamlike, time may be slowed down or sped up, and the world may seem unreal (derealization). You may experience depersonalization, derealization or both. Symptoms, which can be profoundly distressing, may last only a few moments or come and go over many years.

When to see a doctor

Some people with dissociative disorders present in a crisis with traumatic flashbacks that are overwhelming or associated with unsafe behavior. People with these symptoms should be seen in an emergency room.

If you or a loved one has less urgent symptoms that may indicate a dissociative disorder, call your doctor.

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Suicidal thoughts or behavior

If you have thoughts of hurting yourself or someone else, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor.

Risk factors

People who experience long-term physical, sexual or emotional abuse during childhood are at greatest risk of developing dissociative disorders.

Children and adults who experience other traumatic events, such as war, natural disasters, kidnapping, torture, or extended, traumatic, early-life medical procedures, also may develop these conditions.

Complications

People with dissociative disorders are at increased risk of complications and associated disorders, such as:

• Self-harm or mutilation
• Suicidal thoughts and behavior
• Sexual dysfunction
• Alcoholism and drug use disorders
• Depression and anxiety disorders
• Post-traumatic stress disorder
• Personality disorders
• Sleep disorders, including nightmares, insomnia and sleepwalking
• Eating disorders
• Physical symptoms such as lightheadedness or non-epileptic seizures
• Major difficulties in personal relationships and at work

Prevention

Children who are physically, emotionally or sexually abused are at increased risk of developing mental health disorders, such as dissociative disorders. If stress or other personal issues are affecting the way you treat your child, seek help.

• Talk to a trusted person such as a friend, your doctor or a leader in your faith community.
• Ask for help locating resources such as parenting support groups and family therapists.
• Look for churches and community education programs that offer parenting classes that also may help you learn a healthier parenting style.

If your child has been abused or has experienced another traumatic event, see a doctor immediately. Your doctor can refer you to a mental health professional who can help your child recover and adopt healthy coping skills.

Diagnosis of Dissociation

Your doctor will give you a physical exam and ask about any past physical or mental health issues. You should let them know if you take illicit drugs or any medication. They may check a sample of your blood or run other tests to rule out an illness or other medical condition as the cause of your dissociation. They may also order an electroencephalogram (EEG), a painless test that measures brain waves, to rule out certain types of seizure disorders that can sometimes cause dissociation.

Your doctor may then refer you to a mental health specialist. You might see a psychiatrist, psychologist, or psychiatric social worker. They will want to know about any severely troubling events you’ve had in the past.

They may give you other tests, including:

• Dissociative Experiences Scale (DES)
• Structured Clinical Interview for Dissociation

Treatment for Dissociation

There is no specific drug to treat dissociation, but it’s possible to get better with a mix of medication and counseling. Your doctor will tailor your care based on how severe your symptoms are and their cause.

Your treatment may include:

Psychotherapy. This kind of treatment may help you find the cause of your dissociation. But the goal is to help you manage or get rid of your symptoms.

Types of psychotherapy may include:

• Cognitive behavioral therapy. It’s designed to help you see and change negative thoughts and behaviors.
• Hypnotherapy. You may find it easier to explore and process your memories when you are in a relaxed state. You should only do this with a professional certified in hypnosis who is trained in dissociative disorders and PTSD.
• Phasic trauma treatment. This treatment aims to help you stop suicidal thoughts or self-destructive behavior first. Then your psychotherapist will slowly help you process any traumatic memories and re-integrate your identities, if necessary.
• Family treatment. You may find it helpful to get support from a spouse, partner, or other loved one.
• Dialectical behavioral therapy. It may help you learn skills to control your emotions and stop harmful behavior. This is a common treatment for borderline personality disorder.
• Eye movement desensitization and reprocessing. It uses techniques from cognitive behavioral therapy along with visual exercises to help you work through memories of severely troubling events. It may help stop your nightmares, flashbacks, or other PTSD symptoms.

Add-on medication. Your doctor may give you antidepressants, a mood stabilizer, or other drugs to help with anxiety or sleep problems. If you have schizophrenia, you may need an antipsychotic.

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Conversion disorder is a broad term for when mental or emotional distress causes physical symptoms without the existence of an actual physical condition.

When you have conversion disorder, you’re not able to control your physical response. This response usually involves either your senses or your motor control. In other words, you experience a traumatic or stressful event, and your body responds with tremors, paralysis of an arm or leg, or something similar. There isn’t an underlying physical condition, like an injury, causing the tremors or paralysis. Instead, the physical condition is caused by the stress or emotional trauma.

Functional neurologic disorders — a newer and broader term that includes what some people call conversion disorder — feature nervous system (neurological) symptoms that can’t be explained by a neurological disease or other medical condition. However, the symptoms are real and cause significant distress or problems functioning.

Signs and symptoms vary, depending on the type of functional neurologic disorder, and may include specific patterns. Typically these disorders affect your movement or your senses, such as the ability to walk, swallow, see or hear. Symptoms can vary in severity and may come and go or be persistent. However, you can’t intentionally produce or control your symptoms.

The cause of functional neurologic disorders is unknown. The condition may be triggered by a neurological disorder or by a reaction to stress or psychological or physical trauma, but that’s not always the case. Functional neurologic disorders are related to how the brain functions, rather than damage to the brain’s structure (such as from a stroke, multiple sclerosis, infection or injury).

Early diagnosis and treatment, especially education about the condition, can help with recovery.

Causes

Conversion disorder is normally caused by some sort of extreme stress, emotional trauma, or depression. It’s your body’s response to something you perceive as a threat.

The physical symptoms may come about as a way to try and resolve or relieve whatever is causing the extreme mental stress. For example, a police officer or soldier who experiences mental trauma from the thought of shooting and possibly killing someone may have paralysis in their hands. The physical symptoms create a way to avoid whatever is causing the stress.

The exact cause of functional neurologic disorders is unknown. Theories regarding what happens in the brain to result in symptoms are complex and involve multiple mechanisms that may differ, depending on the type of functional neurologic disorder.

Basically, parts of the brain that control the functioning of your muscles and senses may be involved, even though no disease or abnormality exists.

Symptoms of functional neurologic disorders may appear suddenly after a stressful event, or with emotional or physical trauma. Other triggers may include changes or disruptions in how the brain functions at the structural, cellular or metabolic level. But the trigger for symptoms can’t always be identified.

Symptoms

Symptoms of functional neurologic disorders may vary, depending on the type of functional neurologic disorder, and they’re significant enough to cause impairment and warrant medical evaluation. Symptoms can affect body movement and function and the senses.

Signs and symptoms that affect body movement and function may include:

• Weakness or paralysis
• Abnormal movement, such as tremors or difficulty walking
• Loss of balance
• Difficulty swallowing or feeling “a lump in the throat”
• Seizures or episodes of shaking and apparent loss of consciousness (nonepileptic seizures)
• Episodes of unresponsiveness

Signs and symptoms that affect the senses may include:

• Numbness or loss of the touch sensation
• Speech problems, such as inability to speak or slurred speech
• Vision problems, such as double vision or blindness
• Hearing problems or deafness

When to see a doctor

Seek medical attention for signs and symptoms listed above. If the underlying cause is a neurological disease or another medical condition, quick diagnosis and treatment may be important. If the diagnosis is a functional neurologic disorder, treatment may improve the symptoms and help prevent future problems.

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Diagnosis

The diagnosis of conversion disorder comes from meeting certain criteria given by the Diagnostic and Statistical Manual of Mental Disorders. Some of these criteria include:

• symptoms of movement in your body or sensory symptoms that can’t be controlled
• symptoms that happen after or in relation to a stressful event or emotional trauma
• symptoms that can’t be explained medically or physically
• symptoms that negatively affect your daily life

There aren’t specific tests that diagnose conversion disorder. The tests that are performed are primarily to rule out any medical conditions that may be causing your symptoms. The types of tests your doctor may perform during diagnosis depend on the type of symptoms you’re having. Some tests may include:

• CT scan, X-rays, or other imaging to rule out possible injuries and neurological conditions
• electroencephalogram for seizure symptoms to rule out neurological causes
• routine tests such as checking your blood pressure and reflexes

Conversion disorder can have similar symptoms to a number of other medical conditions. Therefore, it’s important for your doctor to rule out other possible causes before coming to a diagnosis of conversion disorder.

Risk factors

Factors that may increase your risk of functional neurologic disorders include:

• Having a neurological disease or disorder, such as epilepsy, migraines or a movement disorder
• Recent significant stress or emotional or physical trauma
• Having a mental health condition, such as a mood or anxiety disorder, dissociative disorder or certain personality disorders
• Having a family member with a functional neurologic disorder
• Possibly, having a history of physical or sexual abuse or neglect in childhood

Women may be more likely than men to develop functional neurologic disorders.

Complications

Some symptoms of functional neurologic disorders, particularly if not treated, can result in substantial disability and poor quality of life, similar to that caused by medical conditions or disease.

Prevention

The primary method of preventing conversion disorder is to find ways to relieve stress and to avoid emotional trauma when possible. Some preventive measures may include:

• getting treatment for any mental or emotional disorder you may have, including depression
• maintaining a good work and life balance
• creating and maintaining positive relationships
• having a secure and calm family atmosphere

You may be unable to control some of these areas. However, if you work toward controlling the areas you can, you may be able to better manage those you can’t. Any reduction in stress and emotional trauma can be effective in helping to prevent conversion disorder.

Conversion Disorder Treatment

Simply knowing that you don’t have a serious physical condition might be enough to stop the symptoms. But getting help from your doctor early on can make you feel better.

They’ll probably recommend psychotherapy treatments, including:

• Occupational or physical therapy
• Counseling
• Hypnosis
• Antidepressants or antipsychotic drugs

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Illness anxiety disorder (IAD), formerly known as hypochondriasis, is a condition marked by an excessive fear of having a serious medical condition despite having few or no symptoms. People who have IAD often go to doctors about symptoms they believe are linked to a medical problem or may believe that mild symptoms are more serious than they really are.

While there may not be a medical illness present, the concerns that people with IAD have are very real, and the anxiety they feel can cause serious disruptions in normal daily functioning.

Illness anxiety disorder, sometimes called hypochondriasis or health anxiety, is worrying excessively that you are or may become seriously ill. You may have no physical symptoms. Or you may believe that normal body sensations or minor symptoms are signs of severe illness, even though a thorough medical exam doesn’t reveal a serious medical condition.

You may experience extreme anxiety that body sensations, such as muscle twitching or fatigue, are associated with a specific, serious illness. This excessive anxiety — rather than the physical symptom itself — results in severe distress that can disrupt your life.

Illness anxiety disorder is a long-term condition that can fluctuate in severity. It may increase with age or during times of stress. But psychological counseling (psychotherapy) and sometimes medication can help ease your worries.

Hypochondriasis

Hypochondriasis, or hypochondria, was eliminated in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).12 Hypochondria was eliminated from the DSM-5 because the term has negative connotations and is stigmatizing.

Instead, most people who would have previously been diagnosed with hypochondriasis now receive a diagnosis of illness anxiety disorder or somatic symptom disorder. However, there are some who feel that hypochondriasis should be reclassified as a phobia since it represents a specific fear.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, no longer includes hypochondriasis — also called hypochondria — as a diagnosis. Instead, people previously diagnosed with hypochondriasis may be diagnosed as having illness anxiety disorder, in which the focus of the fear and worry is on uncomfortable or unusual physical sensations being an indication of a serious medical condition.

On the other hand, somatic symptom disorder ― a related disorder ― involves focusing on the disabling nature of physical symptoms, such as pain or dizziness, without the worry that these symptoms represent a specific illness.

Symptoms

Symptoms of illness anxiety disorder center primarily on a preoccupation with the possibility of being ill, often based on normal body functions or mild physical complaints. Common symptoms include:

• Avoiding people or places out of a fear of contracting an illness
• Constantly searching the internet for information about symptoms and health conditions
• Constantly talking to others about health problems
• Distress that is significant enough to impair normal daily functioning
• Fear that physical sensations are caused by a serious medical disease
• Feeling nervous and obsessed with frequently checking health status
• Heightened awareness of minor bodily symptoms such as headaches, joint pain, or sweating
• Making doctor’s appointments to check up on mild symptoms or normal body functions
• Significant distress over the possibility of being sick

Causes

The exact cause of illness anxiety disorder isn’t clear, but these factors may play a role:

• Beliefs. You may have a difficult time tolerating uncertainty over uncomfortable or unusual body sensations. This could lead you to misinterpret that all body sensations are serious, so you search for evidence to confirm that you have a serious disease.
• Family. You may be more likely to have health anxiety if you had parents who worried too much about their own health or your health.
• Past experience. You may have had experience with serious illness in childhood, so physical sensations may be frightening to you.

The exact causes of illness anxiety disorder are not known, but there are a number of contributing factors that may play a role in the development of this condition. Some of these factors may include:1

• A history of illness during childhood
• Having another mental health condition such as anxiety, obsessive-compulsive disorder, or major depressive disorder
• A history of trauma, abuse, or neglect during childhood
• The presence of a serious symptom that poses a health threat
• Stress
• Feeling uncomfortable when experiencing normal body sensations

Some research also suggests that people may have a higher risk of developing IAD if they spend a great deal of time on the internet reviewing the symptoms of different health conditions.4

Illness anxiety disorder frequently overlaps with other anxiety disorders.3 People who have IAD may also have co-occurring conditions such as specific phobias, generalized anxiety disorder, and/or panic disorder with agoraphobia, among other conditions.

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Types

There are two types of illness anxiety disorder: care-seeking and care-avoidant.

Care-Seeking Type

Some people with illness anxiety disorder react with a need for constant reassurance. They may visit the doctor regularly despite tests showing that everything is normal. They may also frequently complain of their symptoms to friends and family members.

Care-Avoidant Type

Others with IAD react in the opposite extreme. They may avoid visiting the doctor for fear of learning bad news. They may be reluctant to share their fears with loved ones, either because they are afraid of having their fears confirmed or because they believe that they will not be taken seriously.

Risk factors

Illness anxiety disorder usually begins in early or middle adulthood and may get worse with age. Often for older individuals, health-related anxiety may focus on the fear of losing their memory.

Risk factors for illness anxiety disorder may include:

• A time of major life stress
• Threat of a serious illness that turns out not to be serious
• History of abuse as a child
• A serious childhood illness or a parent with a serious illness
• Personality traits, such as having a tendency toward being a worrier
• Excessive health-related internet use

Complications

Illness anxiety disorder may be associated with:

• Relationship or family problems because excessive worrying can frustrate others
• Work-related performance problems or excessive absences
• Problems functioning in daily life, possibly even resulting in disability
• Financial problems due to excessive health care visits and medical bills
• Having another mental health disorder, such as somatic symptom disorder, other anxiety disorders, depression or a personality disorder

Prevention

Little is known about how to prevent illness anxiety disorder, but these suggestions may help.

• If you have problems with anxiety, seek professional advice as soon as possible to help stop symptoms from getting worse and impairing your quality of life.
• Learn to recognize when you’re stressed and how this affects your body — and regularly practice stress management and relaxation techniques.
• Stick with your treatment plan to help prevent relapses or worsening of symptoms.

Treatment

Research has shown that there are treatments that can be effective for illness anxiety disorder.3 Treatment often depends on the nature and severity of the condition, as well as any co-occurring mental health conditions.

Psychotherapy

There are different types of psychotherapy that can be useful for treating illness anxiety. Cognitive behavioral therapy (CBT) has become a popular option for treating IAD. This type of therapy helps people learn to manage the anxiety that they feel towards their physical symptoms. In turn, this can help the symptoms themselves diminish.

Medications

In addition to therapy, medication may be prescribed. Selective serotonin reuptake inhibitors (SSRIs) are a type of medication that can help to treat illness anxiety disorder.5 These drugs are generally known as antidepressants and work by affecting the levels of serotonin in the brain. Examples include Zoloft (sertraline), Paxil (paroxetine) and Prozac (fluoxetine).

Coping

In addition to professional treatment for the condition, there are a number of self-help strategies that people might find helpful for reducing feelings of illness anxiety disorder:

• Manage stress levels. Because stress can contribute to illness anxiety, finding ways to relieve stress may be helpful. Deep breathing, visualization, and progressive muscle relaxation are just a few techniques that you may find helpful for relieving stress.
• Practice mindfulness. Mindfulness is a technique that involves focusing on your body in the present moment. It may help you better understand the normal sensations that you feel each day so that they feel more normal and less like potential health problems.
• Avoid unhelpful information. Constantly reading frightening articles online about health conditions can heighten your anxieties. When you do seek information, look for sources that are trustworthy and reassuring, but avoid constantly reading about health conditions or illnesses.

Physical Therapy Management (current best evidence)

Current evidence on Physical Therapy Management of hypochondriasis is limited.  Due to the psychological nature of the disease there are often no physical symptoms that would benefit from physical therapy.  If a patient is not improving with traditional therapeutic intervention, objective findings do not match the patient’s complaints, and the patient fits the diagnostic criteria for hypochondriasis a referral to their primary care physician would be appropriate.

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Obsessive-compulsive disorder (OCD) features a pattern of unwanted thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress.

You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads to more ritualistic behavior — the vicious cycle of OCD.

OCD often centers around certain themes — for example, an excessive fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they’re sore and chapped.

If you have OCD, you may be ashamed and embarrassed about the condition, but treatment can be effective.

Obsessive-compulsive disorder (OCD) is a chronic mental health condition characterized by obsessions which lead to compulsive behaviors.

People often double check to make sure they’ve locked the front door or always wear their lucky socks on game days — simple rituals or habits that make them feel more secure.

OCD goes beyond double checking something or practicing a game day ritual. Someone diagnosed with OCD feels compelled to act out certain rituals repeatedly, even if they don’t want to — and even if it complicates their life unnecessarily.

What is OCD?

Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions).

Although people with OCD may know that their thoughts and behaviors don’t make logical sense, they’re often unable to stop them.

Causes

The exact cause of OCD is unknown, but researchers believe that certain areas of the brain may not respond normally to serotonin, a chemical that some nerve cells use to communicate with each other.

Genetics are thought to contribute to OCD, as well.

If you, your parent, or a sibling have OCD, there’s about a 25 percent chance that another immediate family member will have it.

The cause of obsessive-compulsive disorder isn’t fully understood. Main theories include:

• Biology. OCD may be a result of changes in your body’s own natural chemistry or brain functions.
• Genetics. OCD may have a genetic component, but specific genes have yet to be identified.
• Learning. Obsessive fears and compulsive behaviors can be learned from watching family members or gradually learned over time.

Symptoms

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it’s also possible to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and interfere with your daily routine and social, school or work functioning.

Obsession symptoms

OCD obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by performing a compulsive behavior or ritual. These obsessions typically intrude when you’re trying to think of or do other things.

Obsessions often have themes to them, such as:

• Fear of contamination or dirt
• Doubting and having difficulty tolerating uncertainty
• Needing things orderly and symmetrical
• Aggressive or horrific thoughts about losing control and harming yourself or others
• Unwanted thoughts, including aggression, or sexual or religious subjects

Examples of obsession signs and symptoms include:

• Fear of being contaminated by touching objects others have touched
• Doubts that you’ve locked the door or turned off the stove
• Intense stress when objects aren’t orderly or facing a certain way
• Images of driving your car into a crowd of people
• Thoughts about shouting obscenities or acting inappropriately in public
• Unpleasant sexual images
• Avoidance of situations that can trigger obsessions, such as shaking hands

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Compulsion symptoms

OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors or mental acts are meant to reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.

You may make up rules or rituals to follow that help control your anxiety when you’re having obsessive thoughts. These compulsions are excessive and often are not realistically related to the problem they’re intended to fix.

As with obsessions, compulsions typically have themes, such as:

• Washing and cleaning
• Checking
• Counting
• Orderliness
• Following a strict routine
• Demanding reassurance

Examples of compulsion signs and symptoms include:

• Hand-washing until your skin becomes raw
• Checking doors repeatedly to make sure they’re locked
• Checking the stove repeatedly to make sure it’s off
• Counting in certain patterns
• Silently repeating a prayer, word or phrase
• Arranging your canned goods to face the same way

Severity varies

OCD usually begins in the teen or young adult years, but it can start in childhood. Symptoms usually begin gradually and tend to vary in severity throughout life. The types of obsessions and compulsions you experience can also change over time. Symptoms generally worsen when you experience greater stress. OCD, usually considered a lifelong disorder, can have mild to moderate symptoms or be so severe and time-consuming that it becomes disabling.

When to see a doctor

There’s a difference between being a perfectionist — someone who requires flawless results or performance, for example — and having OCD. OCD thoughts aren’t simply excessive worries about real problems in your life or liking to have things clean or arranged in a specific way.

If your obsessions and compulsions are affecting your quality of life, see your doctor or mental health professional.

Compulsions

These are repetitive acts that temporarily relieve the stress and anxiety brought on by an obsession. Often, people who have compulsions believe these rituals will prevent something bad from happening.

Types of OCD

There are several different types of obsessions and compulsions. The most well known include:

• obsessions that involve fear of contamination (germs) with related compulsions of cleaning and washing
• obsessions related to symmetry or perfectionism with related compulsions of ordering or redoing

According to Dr. Jill Stoddard, author of “Be Mighty: A Woman’s Guide to Liberation from Anxiety, Worry, and Stress Using Mindfulness and Acceptance,” other obsessions include:

• intrusive and unwanted sexual thoughts
• fear of harming oneself or someone else
• fear of acting impulsively (like blurting out a curse word during a moment of silence). These involve compulsions like checking, counting, praying, and repeating, and can also involve avoidance (different from compulsions) like avoiding sharp objects.

OCD in children

OCD usually develops in children within two age ranges: middle childhood (8–12 years) and between late adolescence and emerging adulthood (18–25 years), says Dr. Steve Mazza, a clinical postdoctoral fellow at the Columbia University Clinic for Anxiety and Related Disorders.

“Girls tend to develop OCD at an older age than boys,” says Mazza. “Although there is a higher rate of OCD in boys than girls during childhood, there are equal rates of OCD between adult men and women.”

OCPD vs OCD

While the names are similar, obsessive-compulsive personality disorder (OCPD) and OCD are very different conditions.

OCD typically involves obsessions that are followed by compulsive behaviors. OCPD describes a set of personality traits that can often interfere with a person’s relationships.

OCPD is characterized by an extreme need for orderliness, perfection, and control, including within interpersonal relationships, says Mazza. Whereas OCD is usually confined to a set of obsessive thoughts and related compulsions.

“People [who have] OCD are more likely to seek help because they are distressed or disturbed by the symptoms,” he says. “People with OCPD may not see their characterological rigidity and need for perfection as problematic, despite its destructive effects on their relationships and well-being.”

OCD diagnosis

OCD is diagnosed by a mental health professional using a semi-structured interview process, according to Mazza.

One of the most widely used instruments is the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which assesses for a variety of the most common obsessions and compulsions, as well as the degree to which OCD symptoms cause a person distress and interfere with their functioning.

Risk factors

Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include:

• Family history. Having parents or other family members with the disorder can increase your risk of developing OCD.
• Stressful life events. If you’ve experienced traumatic or stressful events, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD.
• Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.

Complications

Problems resulting from obsessive-compulsive disorder may include, among others:

• Excessive time spent engaging in ritualistic behaviors
• Health issues, such as contact dermatitis from frequent hand-washing
• Difficulty attending work, school or social activities
• Troubled relationships
• Overall poor quality of life
• Suicidal thoughts and behavior

Prevention

There’s no sure way to prevent obsessive-compulsive disorder. However, getting treatment as soon as possible may help prevent OCD from worsening and disrupting activities and your daily routine.

Treatment

A typical treatment plan for OCD will usually include both psychotherapy and medications. Combining both treatments is usually the most effective.

Medication

Antidepressants are prescribed to help lessen symptoms of OCD.

A selective serotonin reuptake inhibitor (SSRI) is an antidepressant that’s used to reduce obsessive behaviors and compulsions.

Therapy

Talk therapy with a mental health professional can help to provide you with tools that allow changes in thought and behavior patterns.

Cognitive behavior therapy (CBT) and exposure and response therapy are types of talk therapy that are effective for many people.

Exposure and response prevention (ERP) is aimed at allowing a person with OCD to deal with the anxiety associated with obsessive thoughts in other ways, rather than engaging in the compulsive behavior.

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A mood disorder, also referred to as an affective disorder, is a condition that severely impacts mood and its related functions. Mood disorder is a broad term that’s used to include all the different types of depressive and bipolar disorders, both of which affect mood. If you have symptoms of a mood disorder, your moods may range from extremely low (depressed) to extremely high or irritable (manic).

Types of Mood Disorders

With the update of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in 2013, mood disorders are now separated into two groups: bipolar disorder and related disorders and depressive disorders. In general, the main types of mood disorders include:

• Major depressive disorder: This is what we often hear referred to as major depression or clinical depression. It involves periods of extreme sadness, hopelessness, or emptiness accompanied by a variety of physical, cognitive, and emotional symptoms.
• Bipolar I disorder: This disorder was formerly called “manic depression,” Mania is characterized by euphoric and/or irritable moods and increased energy or activity. During manic episodes, people with bipolar I also regularly engage in activities that can result in painful consequences for themselves and/or others.
• Bipolar II disorder: To be diagnosed with bipolar II, a person must have had at least one episode of current or past hypomania (a less severe form of mania), and at least one episode of current or past major depression, but no history of any manic episodes. The criteria for episodes of mania, hypomania, and major depression remain the same.
• Cyclothymic disorder:Diagnosis requires a minimum two-year history of many episodes of not-quite hypomania and not-quite major depression.
• Other: There are other categories of mood disorders that include substance/medication and medically induced mood disorders. There are also “other specified” and “unspecified” mood disorders that don’t exactly meet criteria for the other mood disorders.

New Mood Disorders

There are three new depressive disorders included in the DSM-V.

• Disruptive mood dysregulation disorder: This depressive disorder was added to the DSM-Vfor children up to 18 years of age who exhibit persistent irritability and anger and frequent episodes of extreme temper outbursts without any significant provocation.
• Persistent depressive disorder: This diagnosis is meant to include both chronic major depressive disorder that has lasted for two or more years and what was previously known as dysthymic disorder or dysthymia, a lower grade form of depression.
• Premenstrual dysphoric disorder: This diagnosis is based on the presence of one or more specific symptoms in the week before the onset of menstruation, followed by the resolution of these symptoms after onset. The symptoms include mood swings, irritability or anger, depressed mood or hopelessness, and anxiety or tension, as well as one or more of an additional seven symptoms, for a total of at least five symptoms.

Causes

No one knows the exact causes of mood disorders, but a variety of factors seem to contribute to them and they tend to run in families. Chemical imbalances in the brain are the most likely cause. Stressful life events like death, divorce, or trauma can also trigger depression, especially if someone has already had it before or there’s a genetic component.

Symptoms of Mood Disorders

Mood disorders can lead to difficulty in keeping up with the daily tasks and demands of life. Some people, especially children, may have physical symptoms of depression, like unexplained headaches or stomachaches. Because there are various types of mood disorders, they can have very different effects on quality of life. In general, symptoms may include:

• Loss of interest in activities one once enjoyed
• Eating more or less than usual
• Difficulty sleeping or sleeping more than usual
• Fatigue
• Crying
• Anxiety
• Feeling “flat,” having no energy to care
• Feeling isolated, sad, hopeless, and worthless
• Difficulty concentrating
• Problems making decisions
• Feelings of guilt
• Irritability
• Thoughts of dying and/or suicide

With mood disorders, these symptoms are ongoing and eventually start to affect daily life in a negative way. They’re not the sporadic thoughts and feelings that everyone has on occasion.

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Diagnosis

Mood disorders should be properly evaluated and treated by a mental health professional, such as a psychiatrist. If any of the symptoms above have been interfering with your life, particularly if you are having suicidal thoughts, you should seek help immediately.

Your doctor will be able to diagnose you by performing a physical exam and lab tests to rule out any physical reasons for your symptoms along with a psychiatric evaluation.

Treatment

Millions of people experience mood disorders and are successfully treated, helping them live a better quality of life. Treatments for mood disorders can include psychotherapy, also known as talk therapy, as well as medications to help regulate chemical imbalances in the brain. A combination of psychotherapy and medication is often the best course of action.

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Formally classified as “feeding and eating disorders” in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the term “eating disorders” represents a group of complex mental health conditions that can seriously impair health and social functioning

Because of the physical nature of their defining symptoms, eating disorders can cause both emotional distress and significant medical complications. They also have the highest mortality rate of any mental disorder.

Eating disorders are serious conditions related to persistent eating behaviors that negatively impact your health, your emotions and your ability to function in important areas of life. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.

Most eating disorders involve focusing too much on your weight, body shape and food, leading to dangerous eating behaviors. These behaviors can significantly impact your body’s ability to get appropriate nutrition. Eating disorders can harm the heart, digestive system, bones, and teeth and mouth, and lead to other diseases.

Eating disorders often develop in the teen and young adult years, although they can develop at other ages. With treatment, you can return to healthier eating habits and sometimes reverse serious complications caused by the eating disorder.

Types

There are many types of feeding and eating disorders, and they all come with their own defining characteristics and diagnostic criteria. The eating disorders formally recognized the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the official guidebook to the diagnosis of psychiatric disorders used by mental health providers, include the following.

Binge Eating Disorder (BED)

Binge eating disorder, the most recently recognized eating disorder, is actually the most common. It is characterized by repeated episodes of binge eating—defined as the consumption of a large amount of food accompanied by a feeling of loss of control. It is found in higher rates among people of larger body size. Weight stigma is commonly a confounding element in the development and treatment of BED.

Bulimia Nervosa (BN)

Bulimia nervosa involves recurrent episodes of binge eating followed by compensatory behaviors—behaviors designed to make up for the calories consumed. These behaviors may include vomiting, fasting, excessive exercise, and laxative use.

Anorexia Nervosa (AN)

Anorexia nervosa is characterized by the restricted intake of food which leads to a lower than expected body weight, fear of weight gain, and disturbance in body image. Many people are unaware that anorexia nervosa can also be diagnosed in individuals with larger bodies. Despite the fact that anorexia is the eating disorder that receives the most attention, it is actually the least common.

Other Specified Feeding and Eating Disorder (OSFED)

Other specified feeding and eating disorder is a catchall category that includes a wide range of eating problems that cause significant distress and impairment but do not meet the specific criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder. OSFED, along with unspecified feeding or eating disorder (UFED), replaced the eating disorder not otherwise specified (EDNOS) category in previous versions of the DSM.

People who are diagnosed with OSFED often feel invalidated and unworthy of help, which is not true. OSFED can also be as serious as other eating disorders and can include subclinical eating disorders.

Research shows that many people with subclinical eating disorders will go on to develop full eating disorders. Subclinical eating disorders can also describe a phase that many people in recovery pass through on their way to full recovery.

Avoidant/Restrictive Food Intake Disorder (ARFID)

Previously called selective eating disorder, avoidant/restrictive food intake disorder (ARFID) is an eating disorder that involves a restricted food intake in the absence of the body image disturbance commonly seen in anorexia nervosa. It is manifested by persistent failure to meet appropriate nutritional and/or energy needs.

Orthorexia Nervosa

Orthorexia nervosa is not an official eating disorder in the DSM-5, though it has attracted a great deal of recent attention as a proposed diagnosis for future editions. It differs from other eating disorders because the unhealthy obsession does not typically come from a desire to lose weight. Further, the focus is not on food quantity, but rather food quality. Orthorexia nervosa is an unhealthy obsession with healthy eating and involves adhering to a theory of healthy eating to the point that one experiences health, social, and occupational consequences.

Other Eating Disorders

In addition to the ones listed above, other eating disorders include:

• Night eating syndrome
• Pica
• Purging disorder
• Rumination disorder

Pica

Pica is another eating disorder that involves eating things that are not considered food.

Individuals with pica crave non-food substances, such as ice, dirt, soil, chalk, soap, paper, hair, cloth, wool, pebbles, laundry detergent, or cornstarch.

Pica can occur in adults, as well as children and adolescents. That said, this disorder is most frequently observed in children, pregnant women, and individuals with mental disabilities.

Individuals with pica may be at an increased risk of poisoning, infections, gut injuries, and nutritional deficiencies. Depending on the substances ingested, pica may be fatal.

However, to be considered pica, the eating of non-food substances must not be a normal part of someone’s culture or religion. In addition, it must not be considered a socially acceptable practice by a person’s peers.

Summary Individuals with pica tend to crave and eat non-food substances. This disorder may particularly affect children, pregnant women, and individuals with mental disabilities.

Rumination disorder

Rumination disorder is another newly recognized eating disorder.

It describes a condition in which a person regurgitates food they have previously chewed and swallowed, re-chews it, and then either re-swallows it or spits it out.

This rumination typically occurs within the first 30 minutes after a meal. Unlike medical conditions like reflux, it’s voluntary.

This disorder can develop during infancy, childhood, or adulthood. In infants, it tends to develop between 3–12 months of age and often disappears on its own. Children and adults with the condition usually require therapy to resolve it.

If not resolved in infants, rumination disorder can result in weight loss and severe malnutrition that can be fatal.

Adults with this disorder may restrict the amount of food they eat, especially in public. This may lead them to lose weight and become underweight.

Summary Rumination disorder can affect people at all stages of life. People with the condition generally regurgitate the food they’ve recently swallowed. Then, they chew it again and either swallow it or spit it out.

Symptoms

Symptoms vary, depending on the type of eating disorder. Anorexia nervosa, bulimia nervosa and binge-eating disorder are the most common eating disorders. Other eating disorders include rumination disorder and avoidant/restrictive food intake disorder.

Anorexia nervosa

Anorexia (an-o-REK-see-uh) nervosa — often simply called anorexia — is a potentially life-threatening eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of weight or shape. People with anorexia use extreme efforts to control their weight and shape, which often significantly interferes with their health and life activities.

When you have anorexia, you excessively limit calories or use other methods to lose weight, such as excessive exercise, using laxatives or diet aids, or vomiting after eating. Efforts to reduce your weight, even when underweight, can cause severe health problems, sometimes to the point of deadly self-starvation.

Bulimia nervosa

Bulimia (boo-LEE-me-uh) nervosa — commonly called bulimia — is a serious, potentially life-threatening eating disorder. When you have bulimia, you have episodes of bingeing and purging that involve feeling a lack of control over your eating. Many people with bulimia also restrict their eating during the day, which often leads to more binge eating and purging.

During these episodes, you typically eat a large amount of food in a short time, and then try to rid yourself of the extra calories in an unhealthy way. Because of guilt, shame and an intense fear of weight gain from overeating, you may force vomiting or you may exercise too much or use other methods, such as laxatives, to get rid of the calories.

If you have bulimia, you’re probably preoccupied with your weight and body shape, and may judge yourself severely and harshly for your self-perceived flaws. You may be at a normal weight or even a bit overweight.

Binge-eating disorder

When you have binge-eating disorder, you regularly eat too much food (binge) and feel a lack of control over your eating. You may eat quickly or eat more food than intended, even when you’re not hungry, and you may continue eating even long after you’re uncomfortably full.

After a binge, you may feel guilty, disgusted or ashamed by your behavior and the amount of food eaten. But you don’t try to compensate for this behavior with excessive exercise or purging, as someone with bulimia or anorexia might. Embarrassment can lead to eating alone to hide your bingeing.

A new round of bingeing usually occurs at least once a week. You may be normal weight, overweight or obese.

Rumination disorder

Rumination disorder is repeatedly and persistently regurgitating food after eating, but it’s not due to a medical condition or another eating disorder such as anorexia, bulimia or binge-eating disorder. Food is brought back up into the mouth without nausea or gagging, and regurgitation may not be intentional. Sometimes regurgitated food is rechewed and reswallowed or spit out.

The disorder may result in malnutrition if the food is spit out or if the person eats significantly less to prevent the behavior. The occurrence of rumination disorder may be more common in infancy or in people who have an intellectual disability.

Avoidant/restrictive food intake disorder

This disorder is characterized by failing to meet your minimum daily nutrition requirements because you don’t have an interest in eating; you avoid food with certain sensory characteristics, such as color, texture, smell or taste; or you’re concerned about the consequences of eating, such as fear of choking. Food is not avoided because of fear of gaining weight.

The disorder can result in significant weight loss or failure to gain weight in childhood, as well as nutritional deficiencies that can cause health problems.

When to see a doctor

An eating disorder can be difficult to manage or overcome by yourself. Eating disorders can virtually take over your life. If you’re experiencing any of these problems, or if you think you may have an eating disorder, seek medical help.

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Urging a loved one to seek treatment

Unfortunately, many people with eating disorders may not think they need treatment. If you’re worried about a loved one, urge him or her to talk to a doctor. Even if your loved one isn’t ready to acknowledge having an issue with food, you can open the door by expressing concern and a desire to listen.

Be alert for eating patterns and beliefs that may signal unhealthy behavior, as well as peer pressure that may trigger eating disorders. Red flags that may indicate an eating disorder include:

• Skipping meals or making excuses for not eating
• Adopting an overly restrictive vegetarian diet
• Excessive focus on healthy eating
• Making own meals rather than eating what the family eats
• Withdrawing from normal social activities
• Persistent worry or complaining about being fat and talk of losing weight
• Frequent checking in the mirror for perceived flaws
• Repeatedly eating large amounts of sweets or high-fat foods
• Use of dietary supplements, laxatives or herbal products for weight loss
• Excessive exercise
• Calluses on the knuckles from inducing vomiting
• Problems with loss of tooth enamel that may be a sign of repeated vomiting
• Leaving during meals to use the toilet
• Eating much more food in a meal or snack than is considered normal
• Expressing depression, disgust, shame or guilt about eating habits
• Eating in secret

If you’re worried that your child may have an eating disorder, contact his or her doctor to discuss your concerns. If needed, you can get a referral to a qualified mental health professional with expertise in eating disorders, or if your insurance permits it, contact an expert directly.

Causes

Eating disorders are complex illnesses. While we do not definitively know what causes them, some theories exist.

It appears that 50% to 80% of the risk for developing an eating disorder is genetic, but genes alone do not predict who will develop an eating disorder. It is often said that “genes load the gun, but environment pulls the trigger.”6

Certain situations and events—often called “precipitating factors”—contribute to or trigger the development of eating disorders in those who are genetically vulnerable.

Some environmental factors implicated as precipitants include:

• Abuse
• Bullying
• Dieting
• Life transitions
• Mental illness
• Puberty
• Stress
• Weight stigma

It has also become common to blame eating disorders on the media. While media influence is recognized as a complicating factor, it isn’t considered an underlying cause of eating disorder development in individuals. Ultimately, a person must also have a genetic vulnerability in order for eating disorders to develop.

The exact cause of eating disorders is unknown. As with other mental illnesses, there may be many causes, such as:

• Genetics and biology. Certain people may have genes that increase their risk of developing eating disorders. Biological factors, such as changes in brain chemicals, may play a role in eating disorders.
• Psychological and emotional health. People with eating disorders may have psychological and emotional problems that contribute to the disorder. They may have low self-esteem, perfectionism, impulsive behavior and troubled relationships

Diagnosis

Eating disorders can be diagnosed by medical physicians or mental health professionals, including psychiatrists and psychologists. Often, a pediatrician or primary care doctor will diagnose an eating disorder after noticing symptoms during a regular check-up or after a parent or family member expresses concern over their loved one’s behavior.

Although there is no one laboratory test to screen for eating disorders, your doctor can use a variety of physical and psychological evaluations as well as lab tests to determine your diagnosis, including:

• A physical exam, during which your provider will check your height, weight, and vital signs
• Lab tests, including a complete blood count, liver, kidney, and thyroid function tests, urinalysis, X-ray, and an electrocardiogram
• Psychological evaluation, which includes personal questions about your eating behaviors, binging, purging, exercise habits, and body image

There are also multiple questionnaires and assessment tools used to assess a person’s symptoms, including:

• Eating Disorder Inventory
• SCOFF Questionnaire
• Eating Attitudes Test
• Eating Disorder Examination Questionnaire (EDE-Q)

Risk factors

Teenage girls and young women are more likely than teenage boys and young men to have anorexia or bulimia, but males can have eating disorders, too. Although eating disorders can occur across a broad age range, they often develop in the teens and early 20s.

Certain factors may increase the risk of developing an eating disorder, including:

• Family history. Eating disorders are significantly more likely to occur in people who have parents or siblings who’ve had an eating disorder.
• Other mental health disorders. People with an eating disorder often have a history of an anxiety disorder, depression or obsessive-compulsive disorder.
• Dieting and starvation. Dieting is a risk factor for developing an eating disorder. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite. There is strong evidence that many of the symptoms of an eating disorder are actually symptoms of starvation. Starvation and weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits.
• Stress. Whether it’s heading off to college, moving, landing a new job, or a family or relationship issue, change can bring stress, which may increase your risk of an eating disorder.

Complications

Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely you are to experience serious complications, such as:

• Serious health problems
• Depression and anxiety
• Suicidal thoughts or behavior
• Problems with growth and development
• Social and relationship problems
• Substance use disorders
• Work and school issues
• Death

Prevention

Although there’s no sure way to prevent eating disorders, here are some strategies to help your child develop healthy-eating behaviors:

• Avoid dieting around your child. Family dining habits may influence the relationships children develop with food. Eating meals together gives you an opportunity to teach your child about the pitfalls of dieting and encourages eating a balanced diet in reasonable portions.
• Talk to your child. For example, there are numerous websites that promote dangerous ideas, such as viewing anorexia as a lifestyle choice rather than an eating disorder. It’s crucial to correct any misperceptions like this and to talk to your child about the risks of unhealthy eating choices.
• Cultivate and reinforce a healthy body image in your child, whatever his or her shape or size. Talk to your child about self-image and offer reassurance that body shapes can vary. Avoid criticizing your own body in front of your child. Messages of acceptance and respect can help build healthy self-esteem and resilience that will carry children through the rocky periods of the teen years.
• Enlist the help of your child’s doctor. At well-child visits, doctors may be able to identify early indicators of an eating disorder. They can ask children questions about their eating habits and satisfaction with their appearance during routine medical appointments, for instance. These visits should include checks of height and weight percentiles and body mass index, which can alert you and your child’s doctor to any significant changes.

If you notice a family member or friend who seems to show signs of an eating disorder, consider talking to that person about your concern for his or her well-being. Although you may not be able to prevent an eating disorder from developing, reaching out with compassion may encourage the person to seek treatment.

Treatment

Early intervention is associated with an improved outcome, so please do not delay seeking assistance. Life may even need to be put on hold while you focus on getting well. And once you are well, you will be in a much better position to appreciate what life has to offer. Help is available in a variety of formats, although it is common to start treatment with the lowest level of care and progress to higher levels as needed.

Self-Help

Some people with bulimia nervosa and binge eating disorder may be helped by self-help or guided-self help based on the principles of cognitive behavioral therapy (CBT). The person may work through a workbook, manual, or web platform, to learn about the disorder and develop skills to overcome and manage it. Self-help is contraindicated for anorexia nervosa.

Cognitive Behavioral Therapy (CBT)

CBT is the best-studied outpatient therapy for adult eating disorders and includes the following elements:7

• Cognitive restructuring
• Body image exposure
• Delays and alternatives
• Food exposure
• Limiting body-checking
• Meal planning
• Regular eating
• Relapse prevention
• Self-monitoring via paper or applications

Family-Based Treatment (FBT)

Family-based treatment (FBT) is the best-studied treatment for children and adolescents with eating disorders.8 Essentially, the family is a vital part of the treatment team. Parents commonly provide meal support, which allows the young person to recover in their home environment. Another important element of FBT is externalizing the eating disorder.

Nutritional Therapy

A registered dietitian can help you learn (or relearn) the components of a healthy diet and motivate you to make the needed changes.

Weekly Outpatient Treatment

Weekly outpatient treatment is the usual starting point for those who have access to treatment and typically includes treatment by a team of professionals including a therapist, a dietitian, and a medical doctor. Other successful outpatient therapies for adult eating disorders include:

• Dialectical behavior therapy
• Cognitive remediation therapy
• Interpersonal psychotherapy

Intensive Treatment

For people needing a higher level of care, treatment is available at multiple levels, including intensive outpatient, partial hospitalization, residential, and hospital levels of care. In these settings, treatment is almost always provided by a multidisciplinary team.

Coping

Caring for your physical and mental health will go a long way toward helping you cope with an eating disorder. In addition to talking to a therapist or joining a support group (like Eating Disorders Anonymous), seek support from a trusted friend or family member who can be there for you along your path to recovery.

Beyond self-care, it’s also important to identify a few healthy distractions you can turn to when you find yourself obsessing about food and weight or experiencing the urge to turn to disordered eating or behaviors. Here are a few to consider:

• Explore a new hobby, like photography, painting, or knitting
• Invest in an adult coloring book
• Practice mindfulness meditation
• Take a leisurely walk
• Try a yoga class or DVD
• Write in a journal

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Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling.

People with schizophrenia require lifelong treatment. Early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook.

Schizophrenia is a chronic psychiatric disorder. People with this disorder experience distortions of reality, often experiencing delusions or hallucinations.

Although exact estimates are difficulty to obtain, it’s estimated to affect about 1 percent of the population.

Misconceptions about this disorder are common. For example, some people think it creates a “split personality.” In fact, schizophrenia and split personality — properly termed dissociative identity disorder — are two different disorders.

Schizophrenia can occur in men and women of all ages. Men often develop symptoms in their late teens or early 20s. Women tend to show signs in their late 20s and early 30s. Here’s what you need to know.

re common. For example, some people think it creates a “split personality.” In fact, schizophrenia and split personality — properly termed dissociative identity disorder — are two different disorders.

Schizophrenia can occur in men and women of all ages. Men often develop symptoms in their late teens or early 20s. Women tend to show signs in their late 20s and early 30s. Here’s what you need to know.

Symptoms of schizophrenia

Symptoms of schizophrenia may include the following:

Early symptoms

Symptoms of this disorder commonly show up in the teenage years and early 20s. At these ages, the earliest signs may get overlooked because of typical adolescent behaviors.

Early symptoms include:

• isolating oneself from friends and family
• changing friends or social groups
• a change in focus and concentration
• sleep problems
• irritability and agitation
• difficulties with schoolwork, or poor academic performance

Positive symptoms

“Positive” symptoms of schizophrenia are behaviors that aren’t typical in otherwise healthy individuals. These behaviors include:

• Hallucinations. Hallucinations are experiences that appear real but are created by your mind. They include seeing things, hearing voices, or smelling things others around you don’t experience.
• Delusions. A delusion occurs when you believe something despite evidence or facts to the contrary.
• Thought disorders. These are unusual ways of thinking or processing information.
• Movement disorders. These include agitated body movements or strange postures.

Negative symptoms

Negative symptoms of schizophrenia interrupt a person’s typical emotions, behaviors, and abilities. These symptoms include:

• disorganized thinking or speech, where the person changes topics rapidly when speaking or uses made-up words or phrases
• trouble controlling impulses
• odd emotional responses to situations
• a lack of emotion or expressions
• loss of interest or excitement for life
• social isolation
• trouble experiencing pleasure
• difficulty beginning or following through with plans
• difficulty completing normal everyday activities

Cognitive symptoms

Cognitive symptoms of schizophrenia are sometimes subtle and may be difficult to detect. However, the disorder can affect memory and thinking.

These symptoms include:

• disorganized thinking, such as trouble focusing or paying attention
• poor “executive functioning,” or understanding information and using it to make decisions
• problems learning information and using it
• lack of insight or being unaware of their symptoms

Schizophrenia causes

The exact cause of schizophrenia is unknown. Medical researchers believe several factors can contribute, including:

• biological
• genetic
• environmental

Recent studies have suggested that imaging tests completed on people with schizophrenia may show abnormalities in certain brain structures. Ongoing research in this area continues. Chemical abnormalities in the brain are believed to be responsible for many of the symptoms seen in schizophrenia.

Researchers also believe low levels of certain brain chemicals that affect emotions and behavior may contribute to this psychiatric disorder.

Genetics may also play a role. People with a family history of schizophrenia have a higher risk of developing this disorder.

Other risk factors for schizophrenia may include:

• exposure to toxins or a virus before birth or during infancy
• having an inflammatory or an autoimmune disease
• using mind-altering drugs
• high stress levels

It’s not known what causes schizophrenia, but researchers believe that a combination of genetics, brain chemistry and environment contributes to development of the disorder.

Problems with certain naturally occurring brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren’t certain about the significance of these changes, they indicate that schizophrenia is a brain disease.

Subtypes of schizophrenia

Although the subtypes don’t exist as separate clinical disorders anymore, they can still be helpful as specifiers and for treatment planning. There are five classical subtypes:

• paranoid
• hebephrenic
• undifferentiated
• residual
• catatonic

Paranoid schizophrenia

Paranoid schizophrenia used to be the most common form of schizophrenia. In 2013, the American Psychiatric Association determined that paranoia was a positive symptom of the disorder, so paranoid schizophrenia wasn’t a separate condition. Hence, it was then just changed to schizophrenia.

The subtype description is still used though, because of how common it is. Symptoms include:

• delusions
• hallucinations
• disorganized speech (word salad, echolalia)
• trouble concentrating
• behavioral impairment (impulse control, emotional lability)
• flat affect

Did you know?

Word salad is a verbal symptom where random words are strung together in no logical order.

Hebephrenic/disorganized schizophrenia

Hebephrenic or disorganized schizophrenia is still recognized by the International Statistical Classification of Diseases and Related Health Problems (ICD-10), although it’s been removed from the DSM-5.

In this variation of schizophrenia, the individual doesn’t have hallucinations or delusions. Instead, they experience disorganized behavior and speech. This can include:

• flat affect
• speech disturbances
• disorganized thinking
• inappropriate emotions or facial reactions
• trouble with daily activities

Undifferentiated schizophrenia

Undifferentiated schizophrenia was the term used to describe when an individual displayed behaviors that were applicable to more than one type of schizophrenia. For instance, an individual who had catatonic behavior but also had delusions or hallucinations, with word salad, might have been diagnosed with undifferentiated schizophrenia.

With the new diagnostic criteria, this merely signifies to the clinician that a variety of symptoms are present.

Residual schizophrenia

This “subtype” is a bit tricky. It’s been used when a person has a previous diagnosis of schizophrenia but no longer has any prominent symptoms of the disorder. The symptoms have generally lessened in intensity.

Residual schizophrenia usually includes more “negative” symptoms, such as:

• flattened affect
• psychomotor difficulties
• slowed speech
• poor hygiene

Many people with schizophrenia go through periods where their symptoms wax and wane and vary in frequency and intensity. Therefore, this designation is rarely used anymore.

Catatonic schizophrenia

Although catatonic schizophrenia was a subtype in the previous edition of the DSM, it’s been argued in the past that catatonia should be more of a specifier. This is because it occurs in a variety of psychiatric conditions and general medical conditions.

It generally presents itself as immobility, but can also look like:

• mimicking behavior
• mutism
• a stupor-like condition

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Childhood schizophrenia

Childhood schizophrenia isn’t a subtype, but rather used to refer to the time of diagnosis. A diagnosis in children is fairly uncommon.

When it does occur, it can be severe. Early-onset schizophrenia typically occurs between the ages of 13 and 18. A diagnosis under the age of 13 is considered very early-onset, and is extremely rare.

Symptoms in very young children are similar to those of developmental disorders, such as autism and attention-deficit hyperactivity disorder (ADHD). These symptoms can include:

• language delays
• late or unusual crawling or walking
• abnormal motor movements

It’s important to rule out developmental issues when considering a very early-onset schizophrenia diagnosis.

Symptoms in older children and teens include:

• social withdrawal
• sleep disruptions
• impaired school performance
• irritability
• odd behavior
• substance use

Younger individuals are less likely to have delusions, but they’re more likely to have hallucinations. As teens get older, more typical symptoms of schizophrenia like those in adults usually emerge.

Symptoms

Schizophrenia involves a range of problems with thinking (cognition), behavior and emotions. Signs and symptoms may vary, but usually involve delusions, hallucinations or disorganized speech, and reflect an impaired ability to function. Symptoms may include:

• Delusions. These are false beliefs that are not based in reality. For example, you think that you’re being harmed or harassed; certain gestures or comments are directed at you; you have exceptional ability or fame; another person is in love with you; or a major catastrophe is about to occur. Delusions occur in most people with schizophrenia.
• Hallucinations. These usually involve seeing or hearing things that don’t exist. Yet for the person with schizophrenia, they have the full force and impact of a normal experience. Hallucinations can be in any of the senses, but hearing voices is the most common hallucination.
• Disorganized thinking (speech). Disorganized thinking is inferred from disorganized speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can’t be understood, sometimes known as word salad.
• Extremely disorganized or abnormal motor behavior. This may show in a number of ways, from childlike silliness to unpredictable agitation. Behavior isn’t focused on a goal, so it’s hard to do tasks. Behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement.
• Negative symptoms. This refers to reduced or lack of ability to function normally. For example, the person may neglect personal hygiene or appear to lack emotion (doesn’t make eye contact, doesn’t change facial expressions or speaks in a monotone). Also, the person may lose interest in everyday activities, socially withdraw or lack the ability to experience pleasure.

Symptoms can vary in type and severity over time, with periods of worsening and remission of symptoms. Some symptoms may always be present.

In men, schizophrenia symptoms typically start in the early to mid-20s. In women, symptoms typically begin in the late 20s. It’s uncommon for children to be diagnosed with schizophrenia and rare for those older than age 45.

Symptoms in teenagers

Schizophrenia symptoms in teenagers are similar to those in adults, but the condition may be more difficult to recognize. This may be in part because some of the early symptoms of schizophrenia in teenagers are common for typical development during teen years, such as:

• Withdrawal from friends and family
• A drop in performance at school
• Trouble sleeping
• Irritability or depressed mood
• Lack of motivation

Also, recreational substance use, such as marijuana, methamphetamines or LSD, can sometimes cause similar signs and symptoms.

Compared with schizophrenia symptoms in adults, teens may be:

• Less likely to have delusions
• More likely to have visual hallucinations

When to see a doctor

People with schizophrenia often lack awareness that their difficulties stem from a mental disorder that requires medical attention. So it often falls to family or friends to get them help.

Helping someone who may have schizophrenia

If you think someone you know may have symptoms of schizophrenia, talk to him or her about your concerns. Although you can’t force someone to seek professional help, you can offer encouragement and support and help your loved one find a qualified doctor or mental health professional.

If your loved one poses a danger to self or others or can’t provide his or her own food, clothing, or shelter, you may need to call 911 or other emergency responders for help so that your loved one can be evaluated by a mental health professional.

In some cases, emergency hospitalization may be needed. Laws on involuntary commitment for mental health treatment vary by state. You can contact community mental health agencies or police departments in your area for details.

Suicidal thoughts and behavior

Suicidal thoughts and behavior are common among people with schizophrenia. If you have a loved one who is in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

chizophrenia diagnosis and tests

There isn’t a single test to diagnose schizophrenia. A complete psychiatric exam can help your doctor make a diagnosis. You’ll need to see a psychiatrist or a mental health professional.

At your appointment, expect to answer questions about:

• your medical history
• your mental health
• your family medical history

Your doctor may conduct the following:

• a physical exam
• blood work
• imaging tests, including magnetic resonance imaging (MRI) or computed tomography (CT) scan

Sometimes, there can be other reasons for your symptoms, even though they may be similar to those of schizophrenia. These reasons may include:

• substance use
• certain medications
• other mental illnesses

Your doctor may diagnose schizophrenia if you’ve had at least two symptoms for a one-month period. These symptoms must include:

• hallucinations
• delusions
• disorganized speech

Risk factors

Although the precise cause of schizophrenia isn’t known, certain factors seem to increase the risk of developing or triggering schizophrenia, including:

• Having a family history of schizophrenia
• Some pregnancy and birth complications, such as malnutrition or exposure to toxins or viruses that may impact brain development
• Taking mind-altering (psychoactive or psychotropic) drugs during teen years and young adulthood

Complications

Left untreated, schizophrenia can result in severe problems that affect every area of life. Complications that schizophrenia may cause or be associated with include:

• Suicide, suicide attempts and thoughts of suicide
• Anxiety disorders and obsessive-compulsive disorder (OCD)
• Depression
• Abuse of alcohol or other drugs, including nicotine
• Inability to work or attend school
• Financial problems and homelessness
• Social isolation
• Health and medical problems
• Being victimized
• Aggressive behavior, although it’s uncommon

Prevention

There’s no sure way to prevent schizophrenia, but sticking with the treatment plan can help prevent relapses or worsening of symptoms. In addition, researchers hope that learning more about risk factors for schizophrenia may lead to earlier diagnosis and treatment.

Schizophrenia treatments

There’s no cure for schizophrenia. If you’re diagnosed with this disorder, you’ll need lifelong treatment. Treatments can control or reduce the severity of symptoms.

It’s important to get treatment from a psychiatrist or mental health professional who has experience treating people with this disorder. You may also work with a social worker or a case manager, too.

Possible treatments include the following:

Medications

Antipsychotic medication is the most common treatment for schizophrenia. Medication can help stop:

• hallucinations
• delusions
• symptoms of psychosis

If psychosis occurs, you may be hospitalized and receive treatment under close medical supervision.

Psychosocial intervention

Another treatment option for schizophrenia is psychosocial intervention. This includes individual therapy to help you cope with stress and your illness.

Social training can improve your social and communication skills.

Vocational rehabilitation

Vocational rehabilitation can provide you with the skills you need to return to work. It may make maintaining a regular job easier.

Alternative treatments for schizophrenia

Medication is important for treating schizophrenia. However, some individuals with the disorder may want to consider complementary medicine. If you choose to use these alternative treatments, work with your doctor to make sure the treatment is safe.

Types of alternative treatments used for schizophrenia include:

• vitamin treatment
• fish oil supplements
• glycine supplements
• diet management

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Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels.

Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes their body to skip menstrual periods and makes it harder for them to get pregnant.

PCOS also causes hair growth on the face and body, and baldness. And it can contribute to long-term health problems like diabetes and heart disease.

Birth control pills and diabetes drugs (which combat insulin resistance, a PCOS symptom) can help fix the hormone imbalance and improve symptoms.

Read on for a look at the possible causes of PCOS and its possible effects on a woman’s body.

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

What is PCOS?

PCOS is a problem with hormones that affects women during their childbearing years (ages 15 to 44). Between 2.2 and 26.7 percent of women in this age group have PCOS.

Many women have PCOS but don’t know it. In one study, up to 70 percent of women with PCOS hadn’t been diagnosed.

PCOS affects a woman’s ovaries, the reproductive organs that produce estrogen and progesterone — hormones that regulate the menstrual cycle. The ovaries also produce a small amount of male hormones called androgens.

The ovaries release eggs to be fertilized by a man’s sperm. The release of an egg each month is called ovulation.

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are produced in the pituitary gland, control ovulation.

FSH stimulates the ovary to produce a follicle — a sac that contains an egg — and then LH triggers the ovary to release a mature egg.

PCOS is a “syndrome,” or group of symptoms that affects the ovaries and ovulation. Its three main features are:

• cysts in the ovaries
• high levels of male hormones
• irregular or skipped periods

In PCOS, many small, fluid-filled sacs grow inside the ovaries. The word “polycystic” means “many cysts.”

These sacs are actually follicles, each one containing an immature egg. The eggs never mature enough to trigger ovulation.

The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Progesterone levels are lower than usual, while androgen levels are higher than usual.

Extra male hormones disrupt the menstrual cycle, so women with PCOS get fewer periods than usual.

PCOS isn’t a new condition. Italian physician Antonio Vallisneri first described its symptoms in 172.

causes

Doctors don’t know exactly what causes PCOS. They believe that high levels of male hormones prevent the ovaries from producing hormones and making eggs normally.

Genes, insulin resistance, and inflammation have all been linked to excess androgen production.

Genes

Studies show that PCOS runs in families.

It’s likely that many genes — not just one — contribute to the condition.

Insulin resistance

Up to 70 percent of women with PCOS have insulin resistance, meaning that their cells can’t use insulin properly.

Insulin is a hormone the pancreas produces to help the body use sugar from foods for energy.

When cells can’t use insulin properly, the body’s demand for insulin increases. The pancreas makes more insulin to compensate. Extra insulin triggers the ovaries to produce more male hormones.

Obesity is a major cause of insulin resistance. Both obesity and insulin resistance can increase your risk for type 2 diabetes.

Inflammation

Women with PCOS often have increased levels of inflammation in their body. Being overweight can also contribute to inflammation. Studies have linked excess inflammation to higher androgen levels.

Common symptoms of PCOS

Some women start seeing symptoms around the time of their first period. Others only discover they have PCOS after they’ve gained a lot of weight or they’ve had trouble getting pregnant.

The most common PCOS symptoms are:

• Irregular periods. A lack of ovulation prevents the uterine lining from shedding every month. Some women with PCOS get fewer than eight periods a year or none at all.
• Heavy bleeding. The uterine lining builds up for a longer period of time, so the periods you do get can be heavier than normal.
• Hair growth. More than 70 percent of women with this condition grow hair on their face and body — including on their back, belly, and chest. Excess hair growth is called hirsutism.
• Acne. Male hormones can make the skin oilier than usual and cause breakouts on areas like the face, chest, and upper back.
• Weight gain. Up to 80 percent of women with PCOS are overweight or have obesity.
• Male pattern baldness. Hair on the scalp gets thinner and may fall out.
• Darkening of the skin. Dark patches of skin can form in body creases like those on the neck, in the groin, and under the breasts.
• Headaches. Hormone changes can trigger headaches in some women.

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Complications

Complications of PCOS can include:

• Infertility
• Gestational diabetes or pregnancy-induced high blood pressure
• Miscarriage or premature birth
• Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver
• Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease
• Type 2 diabetes or prediabetes
• Sleep apnea
• Depression, anxiety and eating disorders
• Abnormal uterine bleeding
• Cancer of the uterine lining (endometrial cancer)

Obesity is associated with PCOS and can worsen complications of the disorder.

How PCOS affects your body

Having higher-than-normal androgen levels can affect your fertility and other aspects of your health.

Infertility

To get pregnant, you have to ovulate. Women who don’t ovulate regularly don’t release as many eggs to be fertilized. PCOS is one of the leading causes of infertility in women.

Metabolic syndrome

Up to 80 percent of women with PCOS are overweight or have obesity. Both obesity and PCOS increase your risk for:

• high blood sugar
• high blood pressure
• low HDL “good” cholesterol
• high LDL “bad” cholesterol

Together, these factors are called metabolic syndrome, and they increase the risk for:

• heart disease
• diabetes
• stroke

Sleep apnea

This condition causes repeated pauses in breathing during the night, which interrupt sleep.

Sleep apnea is more common in women who are overweight — especially if they also have PCOS. The risk for sleep apnea is 5 to 10 times higher in women who have both obesity and PCOS than in those without PCOS.

Endometrial cancer

During ovulation, the uterine lining sheds. If you don’t ovulate every month, the lining can build up.

A thickened uterine lining can increase your risk for endometrial cancer.

Depression

Both hormonal changes and symptoms like unwanted hair growth can negatively affect your emotions. Many with PCOS eventually experience depression and anxiety.

How PCOS is diagnosed

Doctors typically diagnose PCOS in women who have at least two of these three symptoms:

• high androgen levels
• irregular menstrual cycles
• cysts in the ovaries

Your doctor should also ask whether you’ve had symptoms like acne, face and body hair growth, and weight gain.

A pelvic exam can look for any problems with your ovaries or other parts of your reproductive tract. During this test, your doctor inserts gloved fingers into your vagina and checks for any growths in your ovaries or uterus.

Blood tests check for higher-than-normal levels of male hormones.

You might also have blood tests to check your cholesterol, insulin, and triglyceride levels to evaluate your risk for related conditions like heart disease and diabetes.

An ultrasound uses sound waves to look for abnormal follicles and other problems with your ovaries and uterus.

Pregnancy and PCOS

PCOS interrupts the normal menstrual cycle and makes it harder to get pregnant. Between 70 and 80 percent of women with PCOS have fertility problems.

This condition can also increase the risk for pregnancy complications.

Women with PCOS are twice as likely as women without the condition to deliver their baby prematurely. They’re also at greater risk for miscarriage, high blood pressure, and gestational diabetes.

However, women with PCOS can get pregnant using fertility treatments that improve ovulation. Losing weight and lowering blood sugar levels can improve your chances of having a healthy pregnancy.

Summary

PCOS can make it harder to get pregnant and increase your risk for pregnancy complications and miscarriage. Weight loss and other treatments can improve your chances of having a healthy pregnancy.

Diet and lifestyle tips to treat PCOS

Treatment for PCOS usually starts with lifestyle changes like weight loss, diet, and exercise.

Losing just 5 to 10 percent of your body weight can help regulate your menstrual cycle and improve PCOS symptoms. Weight loss can also:

• improve cholesterol levels
• lower insulin
• reduce heart disease and diabetes risks

Any diet that helps you lose weight can help your condition. However, some diets may have advantages over others.

Studies comparing diets for PCOS have found that low carbohydrate diets are effective for both weight loss and lowering insulin levels.

A low glycemic index (low GI) diet that gets most carbohydrates from fruits, vegetables, and whole grains helps regulate the menstrual cycle better than a regular weight loss diet.

A few studies have found that 30 minutes of moderate-intensity exercise at least 3 days a week can help women with PCOS lose weight. Losing weight with exercise also improves ovulation and insulin levels.

Exercise is even more beneficial when combined with a healthy diet. Diet plus exercise helps you lose more weight than either intervention alone, and it lowers your risks for diabetes and heart disease.

There is some evidence that acupuncture can help with improving PCOS, but more research is needed.

Summary

PCOS treatment starts with lifestyle changes like diet and exercise. Losing just 5 to 10 percent of your body weight if you’re overweight can help improve your symptoms.

Common medical treatments

Birth control pills and other medications can help regulate the menstrual cycle and treat PCOS symptoms like hair growth and acne.

Birth control

Taking progestin daily can:

• restore a normal hormone balance
• regulate ovulation
• relieve symptoms like excess hair growth
• protect against endometrial cancer

These hormones come in a pill, patch, or vaginal ring.

Metformin

Metformin (Glucophage, Fortamet) is a drug used to treat type 2 diabetes. It also treats PCOS by improving insulin levels.

One study found that taking metformin while making changes to diet and exercise improves weight loss, lowers blood sugar, and restores a normal menstrual cycle better than changes to diet and exercise alone.

Clomiphene

Clomiphene (Clomid) is a fertility drug that can help women with PCOS get pregnant.

It’s important to note that, as you’re discussing family planning, to keep in mind that clomiphene increases the chances for twins and other multiple births.

Hair removal medications

A few treatments can help get rid of unwanted hair or stop it from growing.

Eflornithine (Vaniqa) cream is a prescription drug that slows hair growth. Laser hair removal and electrolysis can get rid of unwanted hair on your face and body.

Surgery

Surgery can be an option to improve fertility if other treatments don’t work. Ovarian drilling is a procedure that makes tiny holes in the ovary with a laser or thin heated needle to restore normal ovulation.

Summary

Birth control pills and the diabetes drug metformin can help bring back a normal menstrual cycle. Clomiphene and surgery improve fertility in women with PCOS. Hair removal medications can help women remove unwanted hair.

When to see a doctor

See your doctor if:

• You’ve missed periods, and you’re not pregnant.
• You have symptoms of PCOS, such as hair growth on your face and body.
• You’ve been trying to get pregnant for more than 12 months but haven’t been successful.
• You have symptoms of diabetes, such as excess thirst or hunger, blurred vision, or unexplained weight loss.

If your periods are already irregular or absent and you’re trying to get pregnant, do not wait 12 months to see a specialist to be evaluated.

Also, keep in mind that if you do not wish to get pregnant, irregular or absent periods are not birth control in themselves.

It may still be possible to get pregnant even under these conditions. It’s best to use contraception in this case even if you have PCOS.

If you have PCOS, plan regular visits with your primary care doctor. You’ll need regular tests to check for diabetes, high blood pressure, and other possible complications.

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